- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,920.50 / $27,634.00
| Facility | | $6,303.00 | $16,920.50 | $27,634.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,348.07 / $30,736.27 / $41,241.44
| Facility | | $22,348.07 | $30,736.27 | $41,241.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,310.33 / $25,144.95 / $35,249.08
| Facility | | $18,310.33 | $25,144.95 | $35,249.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,940.80 / $27,926.29 / $35,205.92
| Facility | | $15,940.80 | $27,926.29 | $35,205.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,483.78 / $26,845.30 / $35,909.97
| Facility | | $16,483.78 | $26,845.30 | $35,909.97 |