- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $41,363.69 / $59,875.50
| Facility | | $3,821.00 | $41,363.69 | $59,875.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,977.66 / $32,619.69 / $55,171.80
| Facility | | $11,977.66 | $32,619.69 | $55,171.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,774.86 / $41,547.51 / $69,541.17
| Facility | | $28,774.86 | $41,547.51 | $69,541.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,629.67 / $46,367.59 / $67,700.45
| Facility | | $35,629.67 | $46,367.59 | $67,700.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,629.67 / $43,104.85 / $67,700.45
| Facility | | $35,629.67 | $43,104.85 | $67,700.45 |