- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,793.40 / $35,592.19
| Facility | | $6,303.00 | $21,793.40 | $35,592.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,783.99 / $39,587.87 / $53,118.38
| Facility | | $28,783.99 | $39,587.87 | $53,118.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,583.44 / $32,386.33 / $45,400.32
| Facility | | $23,583.44 | $32,386.33 | $45,400.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,531.52 / $35,968.66 / $45,344.72
| Facility | | $20,531.52 | $35,968.66 | $45,344.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,531.52 / $36,268.07 / $47,558.27
| Facility | | $20,531.52 | $36,268.07 | $47,558.27 |