- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,301.59 / $28,256.50
| Facility | | $6,303.00 | $17,301.59 | $28,256.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,851.42 / $31,428.55 / $42,170.33
| Facility | | $22,851.42 | $31,428.55 | $42,170.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,722.74 / $25,711.30 / $36,043.01
| Facility | | $18,722.74 | $25,711.30 | $36,043.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,299.84 / $28,555.28 / $35,998.87
| Facility | | $16,299.84 | $28,555.28 | $35,998.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,299.84 / $28,792.99 / $37,756.19
| Facility | | $16,299.84 | $28,792.99 | $37,756.19 |