- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $24,876.80 / $40,628.10
| Facility | | $6,303.00 | $24,876.80 | $40,628.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,252.96 / $45,189.07 / $60,633.98
| Facility | | $27,252.96 | $45,189.07 | $60,633.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,459.03 / $36,968.61 / $51,823.92
| Facility | | $21,459.03 | $36,968.61 | $51,823.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,436.48 / $41,057.78 / $51,760.44
| Facility | | $23,436.48 | $41,057.78 | $51,760.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,436.48 / $41,399.57 / $54,287.19
| Facility | | $23,436.48 | $41,399.57 | $54,287.19 |