- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,288.10 / $24,968.00
| Facility | | $6,303.00 | $15,288.10 | $24,968.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,192.00 / $27,770.93 / $37,262.58
| Facility | | $20,192.00 | $27,770.93 | $37,262.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,543.81 / $22,719.04 / $31,848.37
| Facility | | $16,543.81 | $22,719.04 | $31,848.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,402.88 / $25,232.05 / $31,809.36
| Facility | | $14,402.88 | $25,232.05 | $31,809.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,402.88 / $25,442.09 / $33,362.17
| Facility | | $14,402.88 | $25,442.09 | $33,362.17 |