- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,216.00 / $28,116.70
| Facility | | $6,303.00 | $17,216.00 | $28,116.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,738.37 / $31,273.07 / $41,961.71
| Facility | | $22,738.37 | $31,273.07 | $41,961.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,630.12 / $25,584.10 / $35,864.71
| Facility | | $18,630.12 | $25,584.10 | $35,864.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,219.20 / $28,414.01 / $35,820.78
| Facility | | $16,219.20 | $28,414.01 | $35,820.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,219.20 / $28,650.54 / $37,569.41
| Facility | | $16,219.20 | $28,650.54 | $37,569.41 |