- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,813.09 / $29,091.90
| Facility | | $6,303.00 | $17,813.09 | $29,091.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,527.05 / $32,357.77 / $43,417.14
| Facility | | $23,527.05 | $32,357.77 | $43,417.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,276.30 / $26,471.48 / $37,108.67
| Facility | | $19,276.30 | $26,471.48 | $37,108.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,781.75 / $29,399.55 / $37,063.22
| Facility | | $16,781.75 | $29,399.55 | $37,063.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,781.75 / $29,644.28 / $38,872.50
| Facility | | $16,781.75 | $29,644.28 | $38,872.50 |