- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,659.00 / $25,573.80
| Facility | | $6,303.00 | $15,659.00 | $25,573.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,681.89 / $28,444.70 / $38,166.65
| Facility | | $20,681.89 | $28,444.70 | $38,166.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,945.18 / $23,270.25 / $32,621.07
| Facility | | $16,945.18 | $23,270.25 | $32,621.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,752.32 / $25,844.22 / $32,581.11
| Facility | | $14,752.32 | $25,844.22 | $32,581.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,254.82 / $24,272.18 / $33,232.67
| Facility | | $15,254.82 | $24,272.18 | $33,232.67 |