- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,457.09 / $30,143.70
| Facility | | $6,303.00 | $18,457.09 | $30,143.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,377.63 / $33,527.62 / $44,986.82
| Facility | | $24,377.63 | $33,527.62 | $44,986.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,973.21 / $27,428.52 / $38,450.28
| Facility | | $19,973.21 | $27,428.52 | $38,450.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,388.48 / $30,462.44 / $38,403.18
| Facility | | $17,388.48 | $30,462.44 | $38,403.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,388.48 / $30,716.03 / $40,277.87
| Facility | | $17,388.48 | $30,716.03 | $40,277.87 |