- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $23,392.20 / $38,203.40
| Facility | | $6,303.00 | $23,392.20 | $38,203.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,895.65 / $42,492.13 / $57,015.27
| Facility | | $30,895.65 | $42,492.13 | $57,015.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,313.58 / $34,762.26 / $48,731.00
| Facility | | $25,313.58 | $34,762.26 | $48,731.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,037.76 / $38,607.40 / $48,671.31
| Facility | | $22,037.76 | $38,607.40 | $48,671.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,037.76 / $38,928.78 / $51,047.26
| Facility | | $22,037.76 | $38,928.78 | $51,047.26 |