- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,696.59 / $30,534.70
| Facility | | $6,303.00 | $18,696.59 | $30,534.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,693.91 / $33,962.61 / $45,570.49
| Facility | | $24,693.91 | $33,962.61 | $45,570.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,232.34 / $27,784.38 / $38,949.12
| Facility | | $20,232.34 | $27,784.38 | $38,949.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,614.08 / $30,857.67 / $38,901.43
| Facility | | $17,614.08 | $30,857.67 | $38,901.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,614.08 / $31,114.54 / $40,800.44
| Facility | | $17,614.08 | $31,114.54 | $40,800.44 |