- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $30,741.20 / $50,205.60
| Facility | | $6,303.00 | $30,741.20 | $50,205.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,602.03 / $55,841.72 / $74,927.53
| Facility | | $40,602.03 | $55,841.72 | $74,927.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,266.25 / $45,683.40 / $64,040.63
| Facility | | $33,266.25 | $45,683.40 | $64,040.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,961.28 / $50,736.54 / $63,962.19
| Facility | | $28,961.28 | $50,736.54 | $63,962.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,961.28 / $51,158.89 / $67,084.58
| Facility | | $28,961.28 | $51,158.89 | $67,084.58 |