- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,446.20 / $33,392.19
| Facility | | $6,303.00 | $20,446.20 | $33,392.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,004.76 / $37,140.82 / $49,834.96
| Facility | | $27,004.76 | $37,140.82 | $49,834.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,125.68 / $30,384.43 / $42,593.98
| Facility | | $22,125.68 | $30,384.43 | $42,593.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,262.40 / $33,745.32 / $42,541.81
| Facility | | $19,262.40 | $33,745.32 | $42,541.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,262.40 / $34,026.23 / $44,618.54
| Facility | | $19,262.40 | $34,026.23 | $44,618.54 |