- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,135.50 / $27,985.20
| Facility | | $6,303.00 | $17,135.50 | $27,985.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,632.05 / $31,126.84 / $41,765.50
| Facility | | $22,632.05 | $31,126.84 | $41,765.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,543.00 / $25,464.47 / $35,697.00
| Facility | | $18,543.00 | $25,464.47 | $35,697.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,143.36 / $28,281.15 / $35,653.28
| Facility | | $16,143.36 | $28,281.15 | $35,653.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,143.36 / $28,516.57 / $37,393.74
| Facility | | $16,143.36 | $28,516.57 | $37,393.74 |