- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $25,708.40 / $41,986.10
| Facility | | $6,303.00 | $25,708.40 | $41,986.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,954.80 / $46,699.51 / $62,660.66
| Facility | | $33,954.80 | $46,699.51 | $62,660.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,820.02 / $38,204.26 / $53,556.12
| Facility | | $27,820.02 | $38,204.26 | $53,556.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,219.84 / $42,430.13 / $53,490.53
| Facility | | $24,219.84 | $42,430.13 | $53,490.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,219.84 / $42,783.34 / $56,101.73
| Facility | | $24,219.84 | $42,783.34 | $56,101.73 |