- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,370.60 / $25,102.80
| Facility | | $6,303.00 | $15,370.60 | $25,102.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,046.83 / $26,028.72 / $35,413.04
| Facility | | $18,046.83 | $26,028.72 | $35,413.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,657.30 / $21,984.93 / $30,267.55
| Facility | | $15,657.30 | $21,984.93 | $30,267.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,480.64 / $25,368.27 / $31,981.10
| Facility | | $14,480.64 | $25,368.27 | $31,981.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,973.89 / $23,825.18 / $32,620.66
| Facility | | $14,973.89 | $23,825.18 | $32,620.66 |