- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $23,385.00 / $38,191.69
| Facility | | $6,303.00 | $23,385.00 | $38,191.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,886.23 / $42,479.17 / $56,997.88
| Facility | | $30,886.23 | $42,479.17 | $56,997.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,305.86 / $34,751.67 / $48,716.14
| Facility | | $25,305.86 | $34,751.67 | $48,716.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,031.04 / $38,595.62 / $48,656.47
| Facility | | $22,031.04 | $38,595.62 | $48,656.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,031.04 / $38,916.91 / $51,031.69
| Facility | | $22,031.04 | $38,916.91 | $51,031.69 |