- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,382.00 / $33,287.30
| Facility | | $6,303.00 | $20,382.00 | $33,287.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,328.83 / $37,024.19 / $49,678.49
| Facility | | $22,328.83 | $37,024.19 | $49,678.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,581.75 / $30,289.03 / $42,460.25
| Facility | | $17,581.75 | $30,289.03 | $42,460.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,201.91 / $33,639.36 / $42,408.24
| Facility | | $19,201.91 | $33,639.36 | $42,408.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,201.91 / $33,919.39 / $44,478.45
| Facility | | $19,201.91 | $33,919.39 | $44,478.45 |