- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,729.30 / $25,688.60
| Facility | | $6,303.00 | $15,729.30 | $25,688.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,774.75 / $28,572.42 / $38,338.01
| Facility | | $20,774.75 | $28,572.42 | $38,338.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,021.28 / $23,374.73 / $32,767.54
| Facility | | $17,021.28 | $23,374.73 | $32,767.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,818.56 / $25,960.26 / $32,727.41
| Facility | | $14,818.56 | $25,960.26 | $32,727.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,818.56 / $26,176.37 / $34,325.03
| Facility | | $14,818.56 | $26,176.37 | $34,325.03 |