- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,047.09 / $31,107.20
| Facility | | $6,303.00 | $19,047.09 | $31,107.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,156.89 / $34,599.36 / $46,424.87
| Facility | | $25,156.89 | $34,599.36 | $46,424.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,611.66 / $28,305.30 / $39,679.37
| Facility | | $20,611.66 | $28,305.30 | $39,679.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,944.32 / $31,436.21 / $39,630.78
| Facility | | $17,944.32 | $31,436.21 | $39,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,944.32 / $31,697.89 / $41,565.40
| Facility | | $17,944.32 | $31,697.89 | $41,565.40 |