- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $25,392.50 / $41,470.19
| Facility | | $6,303.00 | $25,392.50 | $41,470.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,537.58 / $46,125.69 / $61,890.72
| Facility | | $33,537.58 | $46,125.69 | $61,890.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,478.18 / $37,734.83 / $52,898.05
| Facility | | $27,478.18 | $37,734.83 | $52,898.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,922.24 / $41,908.76 / $52,833.26
| Facility | | $23,922.24 | $41,908.76 | $52,833.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,922.24 / $42,257.64 / $55,412.38
| Facility | | $23,922.24 | $42,257.64 | $55,412.38 |