- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,189.10 / $34,605.40
| Facility | | $6,303.00 | $21,189.10 | $34,605.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,985.90 / $38,490.21 / $51,645.56
| Facility | | $27,985.90 | $38,490.21 | $51,645.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,929.54 / $31,488.35 / $44,141.50
| Facility | | $22,929.54 | $31,488.35 | $44,141.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,962.24 / $34,971.35 / $44,087.44
| Facility | | $19,962.24 | $34,971.35 | $44,087.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,962.24 / $35,262.47 / $46,239.62
| Facility | | $19,962.24 | $35,262.47 | $46,239.62 |