- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,797.09 / $32,332.10
| Facility | | $6,303.00 | $19,797.09 | $32,332.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,147.45 / $35,961.71 / $48,252.86
| Facility | | $26,147.45 | $35,961.71 | $48,252.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,423.26 / $29,419.82 / $41,241.76
| Facility | | $21,423.26 | $29,419.82 | $41,241.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,650.88 / $32,674.01 / $41,191.25
| Facility | | $18,650.88 | $32,674.01 | $41,191.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,650.88 / $32,946.00 / $43,202.04
| Facility | | $18,650.88 | $32,946.00 | $43,202.04 |