- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $31,682.70 / $51,743.30
| Facility | | $6,303.00 | $31,682.70 | $51,743.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,845.60 / $57,552.07 / $77,222.45
| Facility | | $41,845.60 | $57,552.07 | $77,222.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,285.15 / $47,082.62 / $66,002.10
| Facility | | $34,285.15 | $47,082.62 | $66,002.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,848.32 / $52,290.53 / $65,921.25
| Facility | | $29,848.32 | $52,290.53 | $65,921.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,848.32 / $52,725.81 / $69,139.28
| Facility | | $29,848.32 | $52,725.81 | $69,139.28 |