- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,307.10 / $26,632.20
| Facility | | $6,303.00 | $16,307.10 | $26,632.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,146.34 / $27,614.54 / $37,570.60
| Facility | | $19,146.34 | $27,614.54 | $37,570.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,611.23 / $23,324.37 / $32,111.62
| Facility | | $16,611.23 | $23,324.37 | $32,111.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,362.88 / $26,913.85 / $33,929.56
| Facility | | $15,362.88 | $26,913.85 | $33,929.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,886.18 / $25,872.05 / $34,608.08
| Facility | | $15,886.18 | $25,872.05 | $34,608.08 |