- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,245.90 / $20,936.40 / $32,324.00
| Facility | | $14,245.90 | $20,936.40 | $32,324.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,936.78 / $35,451.37 / $45,450.47
| Facility | | $24,936.78 | $35,451.37 | $45,450.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,033.24 / $31,411.76 / $42,733.09
| Facility | | $16,033.24 | $31,411.76 | $42,733.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,245.90 / $21,414.30 / $34,242.50
| Facility | | $14,245.90 | $21,414.30 | $34,242.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,660.40 / $28,489.49 / $43,283.81
| Facility | | $16,660.40 | $28,489.49 | $43,283.81 |