- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $38,083.10 / $62,196.10
| Facility | | $6,303.00 | $38,083.10 | $62,196.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,720.60 / $69,178.36 / $92,822.42
| Facility | | $41,720.60 | $69,178.36 | $92,822.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,850.87 / $56,593.93 / $79,335.39
| Facility | | $32,850.87 | $56,593.93 | $79,335.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,878.08 / $62,853.91 / $79,238.23
| Facility | | $35,878.08 | $62,853.91 | $79,238.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,878.08 / $63,377.13 / $83,106.34
| Facility | | $35,878.08 | $63,377.13 | $83,106.34 |