- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $27,725.00 / $45,279.60
| Facility | | $6,303.00 | $27,725.00 | $45,279.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,618.26 / $50,362.69 / $67,575.86
| Facility | | $36,618.26 | $50,362.69 | $67,575.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,002.26 / $41,201.07 / $57,757.14
| Facility | | $30,002.26 | $41,201.07 | $57,757.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,119.68 / $45,758.41 / $57,686.40
| Facility | | $26,119.68 | $45,758.41 | $57,686.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,119.68 / $46,139.33 / $60,502.43
| Facility | | $26,119.68 | $46,139.33 | $60,502.43 |