- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $28,009.30 / $45,743.90
| Facility | | $6,303.00 | $28,009.30 | $45,743.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,993.76 / $50,879.12 / $68,268.80
| Facility | | $36,993.76 | $50,879.12 | $68,268.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,309.91 / $41,623.56 / $58,349.40
| Facility | | $30,309.91 | $41,623.56 | $58,349.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,387.52 / $46,227.64 / $58,277.94
| Facility | | $26,387.52 | $46,227.64 | $58,277.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,937.26 / $41,945.16 / $59,443.39
| Facility | | $26,937.26 | $41,945.16 | $59,443.39 |