- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $26,015.10 / $42,487.00
| Facility | | $6,303.00 | $26,015.10 | $42,487.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,359.91 / $47,256.67 / $63,408.25
| Facility | | $34,359.91 | $47,256.67 | $63,408.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,151.93 / $38,660.08 / $54,195.08
| Facility | | $28,151.93 | $38,660.08 | $54,195.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,508.80 / $42,936.35 / $54,128.71
| Facility | | $24,508.80 | $42,936.35 | $54,128.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,508.80 / $43,293.77 / $56,771.06
| Facility | | $24,508.80 | $43,293.77 | $56,771.06 |