- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $22,186.70 / $36,234.60
| Facility | | $6,303.00 | $22,186.70 | $36,234.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,303.50 / $40,302.37 / $54,077.08
| Facility | | $29,303.50 | $40,302.37 | $54,077.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,009.09 / $32,970.85 / $46,219.72
| Facility | | $24,009.09 | $32,970.85 | $46,219.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,902.08 / $36,617.83 / $46,163.11
| Facility | | $20,902.08 | $36,617.83 | $46,163.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,902.08 / $36,922.65 / $48,416.62
| Facility | | $20,902.08 | $36,922.65 | $48,416.62 |