- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $32,018.00 / $52,290.80
| Facility | | $6,303.00 | $32,018.00 | $52,290.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,288.39 / $58,161.06 / $78,039.58
| Facility | | $42,288.39 | $58,161.06 | $78,039.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,647.94 / $47,580.82 / $66,700.50
| Facility | | $34,647.94 | $47,580.82 | $66,700.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,164.16 / $52,843.84 / $66,618.80
| Facility | | $30,164.16 | $52,843.84 | $66,618.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,164.16 / $53,283.73 / $69,870.88
| Facility | | $30,164.16 | $53,283.73 | $69,870.88 |