- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,542.80 / $25,384.00
| Facility | | $6,303.00 | $15,542.80 | $25,384.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,528.46 / $28,233.68 / $37,883.51
| Facility | | $20,528.46 | $28,233.68 | $37,883.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,819.48 / $23,097.62 / $32,379.07
| Facility | | $16,819.48 | $23,097.62 | $32,379.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,642.88 / $25,652.50 / $32,339.41
| Facility | | $14,642.88 | $25,652.50 | $32,339.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,642.88 / $25,866.04 / $33,918.10
| Facility | | $14,642.88 | $25,866.04 | $33,918.10 |