- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,487.70 / $35,093.00
| Facility | | $6,303.00 | $21,487.70 | $35,093.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,380.23 / $39,032.56 / $52,373.28
| Facility | | $28,380.23 | $39,032.56 | $52,373.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,252.63 / $31,932.04 / $44,763.48
| Facility | | $23,252.63 | $31,932.04 | $44,763.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,243.52 / $35,464.12 / $44,708.66
| Facility | | $20,243.52 | $35,464.12 | $44,708.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,243.52 / $35,759.33 / $46,891.16
| Facility | | $20,243.52 | $35,759.33 | $46,891.16 |