- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,419.50 / $25,182.70
| Facility | | $6,303.00 | $15,419.50 | $25,182.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,365.61 / $28,009.71 / $37,582.99
| Facility | | $20,365.61 | $28,009.71 | $37,582.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,686.06 / $22,914.39 / $32,122.21
| Facility | | $16,686.06 | $22,914.39 | $32,122.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,526.72 / $25,449.00 / $32,082.87
| Facility | | $14,526.72 | $25,449.00 | $32,082.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,526.72 / $25,660.85 / $33,649.03
| Facility | | $14,526.72 | $25,660.85 | $33,649.03 |