- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,184.40 / $32,964.50
| Facility | | $6,303.00 | $20,184.40 | $32,964.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,658.87 / $36,665.10 / $49,196.65
| Facility | | $26,658.87 | $36,665.10 | $49,196.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,842.28 / $29,995.25 / $42,048.42
| Facility | | $21,842.28 | $29,995.25 | $42,048.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,015.68 / $33,313.08 / $41,996.92
| Facility | | $19,015.68 | $33,313.08 | $41,996.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,015.68 / $33,590.41 / $44,047.05
| Facility | | $19,015.68 | $33,590.41 | $44,047.05 |