- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $12,312.60 / $20,108.50
| Facility | | $6,303.00 | $12,312.60 | $20,108.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,262.07 / $22,365.94 / $30,010.26
| Facility | | $16,262.07 | $22,365.94 | $30,010.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,323.92 / $18,297.29 / $25,649.79
| Facility | | $13,323.92 | $18,297.29 | $25,649.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,599.68 / $20,321.18 / $25,618.38
| Facility | | $11,599.68 | $20,321.18 | $25,618.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,599.68 / $20,490.34 / $26,868.97
| Facility | | $11,599.68 | $20,490.34 | $26,868.97 |