- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $16,624.00 / $27,149.80
| Facility | | $6,303.00 | $16,624.00 | $27,149.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,956.43 / $30,197.62 / $40,518.69
| Facility | | $21,956.43 | $30,197.62 | $40,518.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,989.45 / $24,704.29 / $34,631.36
| Facility | | $17,989.45 | $24,704.29 | $34,631.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,661.44 / $27,436.89 / $34,588.94
| Facility | | $15,661.44 | $27,436.89 | $34,588.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,661.44 / $27,665.28 / $36,277.44
| Facility | | $15,661.44 | $27,665.28 | $36,277.44 |