- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,407.20 / $30,062.10
| Facility | | $6,303.00 | $18,407.20 | $30,062.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,311.69 / $33,436.92 / $44,865.12
| Facility | | $24,311.69 | $33,436.92 | $44,865.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,919.16 / $27,354.32 / $38,346.26
| Facility | | $19,919.16 | $27,354.32 | $38,346.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,341.43 / $30,380.04 / $38,299.29
| Facility | | $17,341.43 | $30,380.04 | $38,299.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,341.43 / $30,632.93 / $40,168.92
| Facility | | $17,341.43 | $30,632.93 | $40,168.92 |