- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,439.80 / $30,115.40
| Facility | | $6,303.00 | $18,439.80 | $30,115.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,354.75 / $33,496.15 / $44,944.60
| Facility | | $24,354.75 | $33,496.15 | $44,944.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,954.46 / $27,402.77 / $38,414.19
| Facility | | $19,954.46 | $27,402.77 | $38,414.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,372.16 / $30,433.85 / $38,367.14
| Facility | | $17,372.16 | $30,433.85 | $38,367.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,372.16 / $30,687.20 / $40,240.08
| Facility | | $17,372.16 | $30,687.20 | $40,240.08 |