- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $14,713.30 / $24,029.40
| Facility | | $6,303.00 | $14,713.30 | $24,029.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,432.93 / $26,726.95 / $35,861.80
| Facility | | $19,432.93 | $26,726.95 | $35,861.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,921.89 / $21,864.98 / $30,651.11
| Facility | | $15,921.89 | $21,864.98 | $30,651.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,861.44 / $24,283.51 / $30,613.57
| Facility | | $13,861.44 | $24,283.51 | $30,613.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,150.22 / $21,290.31 / $31,225.78
| Facility | | $14,150.22 | $21,290.31 | $31,225.78 |