- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,361.70 / $28,354.60
| Facility | | $6,303.00 | $17,361.70 | $28,354.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,930.83 / $31,537.76 / $42,316.87
| Facility | | $22,930.83 | $31,537.76 | $42,316.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,787.80 / $25,800.64 / $36,168.26
| Facility | | $18,787.80 | $25,800.64 | $36,168.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,356.48 / $28,654.51 / $36,123.97
| Facility | | $16,356.48 | $28,654.51 | $36,123.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,356.48 / $28,893.04 / $37,887.40
| Facility | | $16,356.48 | $28,893.04 | $37,887.40 |