- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,440.80 / $30,117.00
| Facility | | $6,303.00 | $18,440.80 | $30,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,356.10 / $33,498.00 / $44,947.08
| Facility | | $24,356.10 | $33,498.00 | $44,947.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,955.56 / $27,404.29 / $38,416.31
| Facility | | $19,955.56 | $27,404.29 | $38,416.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,373.12 / $30,435.53 / $38,369.26
| Facility | | $17,373.12 | $30,435.53 | $38,369.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,373.12 / $30,688.89 / $40,242.30
| Facility | | $17,373.12 | $30,688.89 | $40,242.30 |