- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,492.09 / $33,467.10
| Facility | | $6,303.00 | $20,492.09 | $33,467.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,065.33 / $37,224.11 / $49,946.72
| Facility | | $27,065.33 | $37,224.11 | $49,946.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,175.30 / $30,452.57 / $42,689.51
| Facility | | $22,175.30 | $30,452.57 | $42,689.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,305.59 / $33,821.00 / $42,637.22
| Facility | | $19,305.59 | $33,821.00 | $42,637.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,305.59 / $34,102.54 / $44,718.61
| Facility | | $19,305.59 | $34,102.54 | $44,718.61 |