- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,766.90 / $30,649.60
| Facility | | $6,303.00 | $18,766.90 | $30,649.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,786.78 / $34,090.33 / $45,741.86
| Facility | | $24,786.78 | $34,090.33 | $45,741.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,308.43 / $27,888.86 / $39,095.61
| Facility | | $20,308.43 | $27,888.86 | $39,095.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,680.32 / $30,973.71 / $39,047.72
| Facility | | $17,680.32 | $30,973.71 | $39,047.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,680.32 / $31,231.55 / $40,953.87
| Facility | | $17,680.32 | $31,231.55 | $40,953.87 |