- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,494.20 / $28,571.00
| Facility | | $6,303.00 | $17,494.20 | $28,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,105.79 / $31,778.40 / $42,639.75
| Facility | | $23,105.79 | $31,778.40 | $42,639.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,931.15 / $25,997.50 / $36,444.23
| Facility | | $18,931.15 | $25,997.50 | $36,444.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,481.28 / $28,873.14 / $36,399.58
| Facility | | $16,481.28 | $28,873.14 | $36,399.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,481.28 / $29,113.49 / $38,176.48
| Facility | | $16,481.28 | $29,113.49 | $38,176.48 |