- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $15,617.20 / $25,505.50
| Facility | | $6,303.00 | $15,617.20 | $25,505.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,626.71 / $28,368.81 / $38,064.82
| Facility | | $20,626.71 | $28,368.81 | $38,064.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,899.98 / $23,208.16 / $32,534.03
| Facility | | $16,899.98 | $23,208.16 | $32,534.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,712.96 / $24,777.00 / $32,494.19
| Facility | | $14,712.96 | $24,777.00 | $32,494.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,712.96 / $25,989.83 / $34,080.43
| Facility | | $14,712.96 | $25,989.83 | $34,080.43 |