- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,115.80 / $24,686.70
| Facility | | $6,303.00 | $15,115.80 | $24,686.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,964.55 / $27,458.10 / $36,842.85
| Facility | | $19,964.55 | $27,458.10 | $36,842.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,357.45 / $22,463.13 / $31,489.62
| Facility | | $16,357.45 | $22,463.13 | $31,489.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,240.64 / $24,947.82 / $31,451.05
| Facility | | $14,240.64 | $24,947.82 | $31,451.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,240.64 / $25,155.50 / $32,986.37
| Facility | | $14,240.64 | $25,155.50 | $32,986.37 |