- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,881.10 / $25,936.60
| Facility | | $6,303.00 | $15,881.10 | $25,936.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,975.29 / $28,848.22 / $38,708.08
| Facility | | $20,975.29 | $28,848.22 | $38,708.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,185.58 / $23,600.37 / $33,083.83
| Facility | | $17,185.58 | $23,600.37 | $33,083.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,961.60 / $26,210.85 / $33,043.32
| Facility | | $14,961.60 | $26,210.85 | $33,043.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,961.60 / $26,429.04 / $34,656.36
| Facility | | $14,961.60 | $26,429.04 | $34,656.36 |