- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $29,676.30 / $48,466.50
| Facility | | $6,303.00 | $29,676.30 | $48,466.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,195.60 / $53,907.40 / $72,332.10
| Facility | | $39,195.60 | $53,907.40 | $72,332.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,113.93 / $44,100.96 / $61,822.30
| Facility | | $32,113.93 | $44,100.96 | $61,822.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,958.08 / $48,979.06 / $61,746.58
| Facility | | $27,958.08 | $48,979.06 | $61,746.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,910.40 / $45,999.78 / $62,981.40
| Facility | | $28,910.40 | $45,999.78 | $62,981.40 |