- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $22,617.70 / $36,938.60
| Facility | | $6,303.00 | $22,617.70 | $36,938.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,872.80 / $41,085.35 / $55,127.67
| Facility | | $29,872.80 | $41,085.35 | $55,127.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,475.53 / $33,611.40 / $47,117.67
| Facility | | $24,475.53 | $33,611.40 | $47,117.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,308.16 / $37,329.23 / $47,059.96
| Facility | | $21,308.16 | $37,329.23 | $47,059.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,308.16 / $37,639.98 / $49,357.25
| Facility | | $21,308.16 | $37,639.98 | $49,357.25 |