- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,056.00 / $32,754.80
| Facility | | $6,303.00 | $20,056.00 | $32,754.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,489.30 / $36,431.87 / $48,883.71
| Facility | | $26,489.30 | $36,431.87 | $48,883.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,703.34 / $29,804.45 / $41,780.94
| Facility | | $21,703.34 | $29,804.45 | $41,780.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,894.72 / $33,101.19 / $41,729.78
| Facility | | $18,894.72 | $33,101.19 | $41,729.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,894.72 / $33,376.74 / $43,766.86
| Facility | | $18,894.72 | $33,376.74 | $43,766.86 |