- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,381.70 / $30,020.50
| Facility | | $6,303.00 | $18,381.70 | $30,020.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,278.04 / $33,390.64 / $44,803.03
| Facility | | $24,278.04 | $33,390.64 | $44,803.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,891.61 / $27,316.46 / $38,293.19
| Facility | | $19,891.61 | $27,316.46 | $38,293.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,317.43 / $30,337.99 / $38,246.29
| Facility | | $17,317.43 | $30,337.99 | $38,246.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,317.43 / $30,590.54 / $40,113.32
| Facility | | $17,317.43 | $30,590.54 | $40,113.32 |