- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,267.70 / $24,934.70
| Facility | | $6,303.00 | $15,267.70 | $24,934.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,165.08 / $27,733.91 / $37,212.92
| Facility | | $20,165.08 | $27,733.91 | $37,212.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,521.75 / $22,688.76 / $31,805.91
| Facility | | $16,521.75 | $22,688.76 | $31,805.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,383.68 / $25,198.41 / $31,766.96
| Facility | | $14,383.68 | $25,198.41 | $31,766.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,683.34 / $22,864.06 / $32,402.24
| Facility | | $14,683.34 | $22,864.06 | $32,402.24 |