- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,268.59 / $29,835.80
| Facility | | $6,303.00 | $18,268.59 | $29,835.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,128.65 / $33,185.18 / $44,527.34
| Facility | | $24,128.65 | $33,185.18 | $44,527.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,769.21 / $27,148.37 / $38,057.56
| Facility | | $19,769.21 | $27,148.37 | $38,057.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,210.88 / $30,151.31 / $38,010.94
| Facility | | $17,210.88 | $30,151.31 | $38,010.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,210.88 / $30,402.30 / $39,866.49
| Facility | | $17,210.88 | $30,402.30 | $39,866.49 |