- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $26,318.70 / $42,983.00
| Facility | | $6,303.00 | $26,318.70 | $42,983.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,760.98 / $47,808.27 / $64,148.38
| Facility | | $34,760.98 | $47,808.27 | $64,148.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,480.54 / $39,111.33 / $54,827.68
| Facility | | $28,480.54 | $39,111.33 | $54,827.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,794.88 / $43,437.53 / $54,760.53
| Facility | | $24,794.88 | $43,437.53 | $54,760.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,794.88 / $43,799.12 / $57,433.72
| Facility | | $24,794.88 | $43,799.12 | $57,433.72 |