- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $18,655.90 / $30,468.20
| Facility | | $6,303.00 | $18,655.90 | $30,468.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,640.08 / $33,888.57 / $45,471.14
| Facility | | $24,640.08 | $33,888.57 | $45,471.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,188.23 / $27,723.80 / $38,864.22
| Facility | | $20,188.23 | $27,723.80 | $38,864.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,575.68 / $30,790.39 / $38,816.62
| Facility | | $17,575.68 | $30,790.39 | $38,816.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,575.68 / $31,046.71 / $40,711.50
| Facility | | $17,575.68 | $31,046.71 | $40,711.50 |