- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,175.80 / $34,583.69
| Facility | | $6,303.00 | $21,175.80 | $34,583.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,968.40 / $38,466.15 / $51,613.27
| Facility | | $27,968.40 | $38,466.15 | $51,613.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,915.21 / $31,468.67 / $44,113.91
| Facility | | $22,915.21 | $31,468.67 | $44,113.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,949.75 / $34,949.49 / $44,059.88
| Facility | | $19,949.75 | $34,949.49 | $44,059.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,949.75 / $35,240.42 / $46,210.71
| Facility | | $19,949.75 | $35,240.42 | $46,210.71 |