- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,332.90 / $25,041.20
| Facility | | $6,303.00 | $15,332.90 | $25,041.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,251.22 / $27,852.37 / $37,371.87
| Facility | | $20,251.22 | $27,852.37 | $37,371.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,592.33 / $22,785.67 / $31,941.77
| Facility | | $16,592.33 | $22,785.67 | $31,941.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,445.12 / $25,306.04 / $31,902.65
| Facility | | $14,445.12 | $25,306.04 | $31,902.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,445.12 / $25,516.70 / $33,460.01
| Facility | | $14,445.12 | $25,516.70 | $33,460.01 |