- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,418.40 / $30,080.40
| Facility | | $6,303.00 | $18,418.40 | $30,080.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,326.49 / $33,457.28 / $44,892.44
| Facility | | $24,326.49 | $33,457.28 | $44,892.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,931.30 / $27,370.97 / $38,369.61
| Facility | | $19,931.30 | $27,370.97 | $38,369.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,352.00 / $30,398.54 / $38,322.62
| Facility | | $17,352.00 | $30,398.54 | $38,322.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,352.00 / $30,651.59 / $40,193.37
| Facility | | $17,352.00 | $30,651.59 | $40,193.37 |