- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $27,486.50 / $44,890.10
| Facility | | $6,303.00 | $27,486.50 | $44,890.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,303.33 / $49,929.55 / $66,994.67
| Facility | | $36,303.33 | $49,929.55 | $66,994.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,744.23 / $40,846.73 / $57,260.41
| Facility | | $29,744.23 | $40,846.73 | $57,260.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,895.04 / $45,364.87 / $57,190.27
| Facility | | $25,895.04 | $45,364.87 | $57,190.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,895.04 / $45,742.51 / $59,982.08
| Facility | | $25,895.04 | $45,742.51 | $59,982.08 |