- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,059.70 / $34,394.00
| Facility | | $6,303.00 | $21,059.70 | $34,394.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,814.97 / $38,255.12 / $51,330.13
| Facility | | $27,814.97 | $38,255.12 | $51,330.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,789.50 / $31,296.04 / $43,871.91
| Facility | | $22,789.50 | $31,296.04 | $43,871.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,840.32 / $34,757.76 / $43,818.17
| Facility | | $19,840.32 | $34,757.76 | $43,818.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,840.32 / $35,047.10 / $45,957.21
| Facility | | $19,840.32 | $35,047.10 | $45,957.21 |