- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $25,842.90 / $42,205.80
| Facility | | $6,303.00 | $25,842.90 | $42,205.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,132.46 / $46,943.85 / $62,988.51
| Facility | | $34,132.46 | $46,943.85 | $62,988.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,965.57 / $38,404.16 / $53,836.33
| Facility | | $27,965.57 | $38,404.16 | $53,836.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,346.56 / $42,652.13 / $53,770.39
| Facility | | $24,346.56 | $42,652.13 | $53,770.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,346.56 / $43,007.18 / $56,395.26
| Facility | | $24,346.56 | $43,007.18 | $56,395.26 |