- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $23,189.40 / $37,872.19
| Facility | | $6,303.00 | $23,189.40 | $37,872.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,627.83 / $42,123.78 / $56,521.01
| Facility | | $30,627.83 | $42,123.78 | $56,521.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,094.14 / $34,460.93 / $48,308.56
| Facility | | $25,094.14 | $34,460.93 | $48,308.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,846.72 / $38,272.72 / $48,249.39
| Facility | | $21,846.72 | $38,272.72 | $48,249.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,846.72 / $38,591.32 / $50,604.74
| Facility | | $21,846.72 | $38,591.32 | $50,604.74 |