- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,530.80 / $33,530.30
| Facility | | $6,303.00 | $20,530.80 | $33,530.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,116.47 / $37,294.44 / $50,041.10
| Facility | | $27,116.47 | $37,294.44 | $50,041.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,217.20 / $30,510.12 / $42,770.17
| Facility | | $22,217.20 | $30,510.12 | $42,770.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,342.08 / $33,884.91 / $42,717.79
| Facility | | $19,342.08 | $33,884.91 | $42,717.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,342.08 / $34,166.98 / $44,803.11
| Facility | | $19,342.08 | $34,166.98 | $44,803.11 |