- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,025.09 / $29,438.00
| Facility | | $6,303.00 | $18,025.09 | $29,438.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,806.99 / $32,742.78 / $43,933.74
| Facility | | $23,806.99 | $32,742.78 | $43,933.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,505.66 / $26,786.45 / $37,550.21
| Facility | | $19,505.66 | $26,786.45 | $37,550.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,981.43 / $29,749.36 / $37,504.22
| Facility | | $16,981.43 | $29,749.36 | $37,504.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,981.43 / $29,997.01 / $39,335.03
| Facility | | $16,981.43 | $29,997.01 | $39,335.03 |