- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,713.90 / $35,462.40
| Facility | | $6,303.00 | $21,713.90 | $35,462.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,679.02 / $39,443.49 / $52,924.65
| Facility | | $28,679.02 | $39,443.49 | $52,924.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,497.43 / $32,268.22 / $45,234.75
| Facility | | $23,497.43 | $32,268.22 | $45,234.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,456.64 / $35,837.48 / $45,179.34
| Facility | | $20,456.64 | $35,837.48 | $45,179.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,456.64 / $36,135.80 / $47,384.82
| Facility | | $20,456.64 | $36,135.80 | $47,384.82 |