- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,151.50 / $24,745.00
| Facility | | $6,303.00 | $15,151.50 | $24,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,011.65 / $27,522.89 / $36,929.78
| Facility | | $20,011.65 | $27,522.89 | $36,929.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,396.05 / $22,516.13 / $31,563.91
| Facility | | $16,396.05 | $22,516.13 | $31,563.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,274.24 / $25,006.68 / $31,525.25
| Facility | | $14,274.24 | $25,006.68 | $31,525.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,274.24 / $25,214.85 / $33,064.19
| Facility | | $14,274.24 | $25,214.85 | $33,064.19 |