- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,376.59 / $30,012.20
| Facility | | $6,303.00 | $18,376.59 | $30,012.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,271.31 / $33,381.37 / $44,790.61
| Facility | | $24,271.31 | $33,381.37 | $44,790.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,886.09 / $27,308.89 / $38,282.58
| Facility | | $19,886.09 | $27,308.89 | $38,282.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,312.64 / $30,329.58 / $38,235.69
| Facility | | $17,312.64 | $30,329.58 | $38,235.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,312.64 / $30,582.06 / $40,102.21
| Facility | | $17,312.64 | $30,582.06 | $40,102.21 |