- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $29,553.00 / $48,265.10
| Facility | | $6,303.00 | $29,553.00 | $48,265.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,032.75 / $53,683.43 / $72,031.57
| Facility | | $39,032.75 | $53,683.43 | $72,031.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,980.51 / $43,917.73 / $61,565.45
| Facility | | $31,980.51 | $43,917.73 | $61,565.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,841.92 / $48,775.56 / $61,490.04
| Facility | | $27,841.92 | $48,775.56 | $61,490.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,841.92 / $49,181.59 / $64,491.75
| Facility | | $27,841.92 | $49,181.59 | $64,491.75 |