- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $23,957.70 / $39,127.00
| Facility | | $6,303.00 | $23,957.70 | $39,127.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,642.61 / $43,519.45 / $58,393.71
| Facility | | $31,642.61 | $43,519.45 | $58,393.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,925.58 / $35,602.71 / $49,909.15
| Facility | | $25,925.58 | $35,602.71 | $49,909.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,570.56 / $39,540.80 / $49,848.02
| Facility | | $22,570.56 | $39,540.80 | $49,848.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,570.56 / $39,869.94 / $52,281.41
| Facility | | $22,570.56 | $39,869.94 | $52,281.41 |