- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $28,094.80 / $45,883.70
| Facility | | $6,303.00 | $28,094.80 | $45,883.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,106.82 / $51,034.61 / $68,477.42
| Facility | | $37,106.82 | $51,034.61 | $68,477.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,402.54 / $41,750.76 / $58,527.72
| Facility | | $30,402.54 | $41,750.76 | $58,527.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,468.16 / $46,368.91 / $58,456.03
| Facility | | $26,468.16 | $46,368.91 | $58,456.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,468.16 / $46,754.90 / $61,309.63
| Facility | | $26,468.16 | $46,754.90 | $61,309.63 |