- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $32,714.00 / $53,427.50
| Facility | | $6,303.00 | $32,714.00 | $53,427.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,207.62 / $59,425.31 / $79,735.92
| Facility | | $43,207.62 | $59,425.31 | $79,735.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,401.08 / $48,615.09 / $68,150.37
| Facility | | $35,401.08 | $48,615.09 | $68,150.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,819.84 / $53,992.51 / $68,066.89
| Facility | | $30,819.84 | $53,992.51 | $68,066.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,819.84 / $54,441.96 / $71,389.66
| Facility | | $30,819.84 | $54,441.96 | $71,389.66 |