- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,264.20 / $31,461.70
| Facility | | $6,303.00 | $19,264.20 | $31,461.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,443.56 / $34,993.62 / $46,953.89
| Facility | | $25,443.56 | $34,993.62 | $46,953.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,846.54 / $28,627.84 / $40,131.53
| Facility | | $20,846.54 | $28,627.84 | $40,131.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,148.80 / $31,794.43 / $40,082.37
| Facility | | $18,148.80 | $31,794.43 | $40,082.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,148.80 / $32,059.10 / $42,039.05
| Facility | | $18,148.80 | $32,059.10 | $42,039.05 |