- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,443.90 / $30,122.00
| Facility | | $6,303.00 | $18,443.90 | $30,122.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,360.14 / $33,503.55 / $44,954.54
| Facility | | $24,360.14 | $33,503.55 | $44,954.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,958.87 / $27,408.83 / $38,422.68
| Facility | | $19,958.87 | $27,408.83 | $38,422.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,376.00 / $30,440.58 / $38,375.62
| Facility | | $17,376.00 | $30,440.58 | $38,375.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,376.00 / $30,693.98 / $40,248.97
| Facility | | $17,376.00 | $30,693.98 | $40,248.97 |