- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,048.60 / $24,576.90
| Facility | | $6,303.00 | $15,048.60 | $24,576.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,875.72 / $27,335.94 / $36,678.93
| Facility | | $19,875.72 | $27,335.94 | $36,678.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,284.67 / $22,363.18 / $31,349.51
| Facility | | $16,284.67 | $22,363.18 | $31,349.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,177.28 / $24,836.82 / $31,311.11
| Facility | | $14,177.28 | $24,836.82 | $31,311.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,177.28 / $25,043.57 / $32,839.60
| Facility | | $14,177.28 | $25,043.57 | $32,839.60 |