- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,222.80 / $24,861.50
| Facility | | $6,303.00 | $15,222.80 | $24,861.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,676.84 / $27,652.46 / $37,103.64
| Facility | | $16,676.84 | $27,652.46 | $37,103.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,131.38 / $22,622.13 / $31,712.51
| Facility | | $13,131.38 | $22,622.13 | $31,712.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,341.44 / $25,124.41 / $31,673.67
| Facility | | $14,341.44 | $25,124.41 | $31,673.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,341.44 / $25,333.56 / $33,219.85
| Facility | | $14,341.44 | $25,333.56 | $33,219.85 |