- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $32,534.60 / $53,134.60
| Facility | | $6,303.00 | $32,534.60 | $53,134.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,970.75 / $59,099.53 / $79,298.81
| Facility | | $42,970.75 | $59,099.53 | $79,298.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,207.01 / $48,348.57 / $67,776.75
| Facility | | $35,207.01 | $48,348.57 | $67,776.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,650.88 / $53,696.51 / $67,693.75
| Facility | | $30,650.88 | $53,696.51 | $67,693.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,650.88 / $54,143.50 / $70,998.28
| Facility | | $30,650.88 | $54,143.50 | $70,998.28 |