- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,221.50 / $26,492.40
| Facility | | $6,303.00 | $16,221.50 | $26,492.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,424.81 / $29,466.47 / $39,537.64
| Facility | | $21,424.81 | $29,466.47 | $39,537.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,553.88 / $24,106.14 / $33,792.85
| Facility | | $17,553.88 | $24,106.14 | $33,792.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,282.24 / $26,772.57 / $33,751.46
| Facility | | $15,282.24 | $26,772.57 | $33,751.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,282.24 / $26,995.44 / $35,399.08
| Facility | | $15,282.24 | $26,995.44 | $35,399.08 |