- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $28,245.70 / $46,130.00
| Facility | | $6,303.00 | $28,245.70 | $46,130.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,306.00 / $51,308.56 / $68,845.02
| Facility | | $37,306.00 | $51,308.56 | $68,845.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,565.74 / $41,974.88 / $58,841.89
| Facility | | $30,565.74 | $41,974.88 | $58,841.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,610.24 / $46,617.81 / $58,769.82
| Facility | | $26,610.24 | $46,617.81 | $58,769.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,610.24 / $47,005.88 / $61,638.74
| Facility | | $26,610.24 | $47,005.88 | $61,638.74 |