- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,655.50 / $32,100.80
| Facility | | $6,303.00 | $19,655.50 | $32,100.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,053.71 / $35,704.42 / $47,907.63
| Facility | | $25,053.71 | $35,704.42 | $47,907.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,965.47 / $29,209.33 / $40,946.69
| Facility | | $19,965.47 | $29,209.33 | $40,946.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,517.43 / $32,440.24 / $40,896.54
| Facility | | $18,517.43 | $32,440.24 | $40,896.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,517.43 / $32,710.29 / $42,892.95
| Facility | | $18,517.43 | $32,710.29 | $42,892.95 |