- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,959.60 / $26,064.70
| Facility | | $6,303.00 | $15,959.60 | $26,064.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,078.92 / $28,990.75 / $38,899.33
| Facility | | $21,078.92 | $28,990.75 | $38,899.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,270.49 / $23,716.97 / $33,247.29
| Facility | | $17,270.49 | $23,716.97 | $33,247.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,035.52 / $26,340.35 / $33,206.57
| Facility | | $15,035.52 | $26,340.35 | $33,206.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,547.67 / $24,738.13 / $33,870.64
| Facility | | $15,547.67 | $24,738.13 | $33,870.64 |