- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $17,826.40 / $29,113.50
| Facility | | $6,303.00 | $17,826.40 | $29,113.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,544.54 / $32,381.83 / $43,449.43
| Facility | | $23,544.54 | $32,381.83 | $43,449.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,290.63 / $26,491.16 / $37,136.26
| Facility | | $19,290.63 | $26,491.16 | $37,136.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,794.24 / $29,421.41 / $37,090.78
| Facility | | $16,794.24 | $29,421.41 | $37,090.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,794.24 / $29,666.33 / $38,901.41
| Facility | | $16,794.24 | $29,666.33 | $38,901.41 |