- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,424.50 / $30,090.40
| Facility | | $6,303.00 | $18,424.50 | $30,090.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,334.57 / $33,468.37 / $44,907.35
| Facility | | $24,334.57 | $33,468.37 | $44,907.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,937.91 / $27,380.06 / $38,382.35
| Facility | | $19,937.91 | $27,380.06 | $38,382.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,357.75 / $30,408.63 / $38,335.33
| Facility | | $17,357.75 | $30,408.63 | $38,335.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,357.75 / $30,661.76 / $40,206.72
| Facility | | $17,357.75 | $30,661.76 | $40,206.72 |