- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,822.60 / $23,105.70 / $30,368.80
| Facility | | $15,822.60 | $23,105.70 | $30,368.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,335.93 / $17,395.59 / $29,184.71
| Facility | | $6,335.93 | $17,395.59 | $29,184.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,654.00 / $23,315.31 / $42,336.63
| Facility | | $16,654.00 | $23,315.31 | $42,336.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,902.65 / $25,900.83 / $37,817.32
| Facility | | $19,902.65 | $25,900.83 | $37,817.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,902.65 / $24,078.27 / $37,817.32
| Facility | | $19,902.65 | $24,078.27 | $37,817.32 |