- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $30,329.50 / $49,533.20
| Facility | | $6,303.00 | $30,329.50 | $49,533.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,058.30 / $55,093.91 / $73,924.13
| Facility | | $40,058.30 | $55,093.91 | $73,924.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,820.76 / $45,071.63 / $63,183.02
| Facility | | $32,820.76 | $45,071.63 | $63,183.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,573.44 / $50,057.10 / $63,105.63
| Facility | | $28,573.44 | $50,057.10 | $63,105.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,573.44 / $50,473.79 / $66,186.21
| Facility | | $28,573.44 | $50,473.79 | $66,186.21 |