- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $30,778.90 / $50,267.20
| Facility | | $6,303.00 | $30,778.90 | $50,267.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,651.82 / $55,910.21 / $75,019.42
| Facility | | $40,651.82 | $55,910.21 | $75,019.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,307.05 / $45,739.43 / $64,119.17
| Facility | | $33,307.05 | $45,739.43 | $64,119.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,996.80 / $50,798.77 / $64,040.64
| Facility | | $28,996.80 | $50,798.77 | $64,040.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,996.80 / $51,221.64 / $67,166.86
| Facility | | $28,996.80 | $51,221.64 | $67,166.86 |