- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,579.40 / $35,242.80
| Facility | | $6,303.00 | $21,579.40 | $35,242.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,505.96 / $39,199.16 / $52,596.81
| Facility | | $27,505.96 | $39,199.16 | $52,596.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,919.68 / $32,068.33 / $44,954.54
| Facility | | $21,919.68 | $32,068.33 | $44,954.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,329.91 / $35,615.48 / $44,899.48
| Facility | | $20,329.91 | $35,615.48 | $44,899.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,329.91 / $35,615.48 / $47,091.29
| Facility | | $20,329.91 | $35,615.48 | $47,091.29 |