- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,071.20 / $32,779.69
| Facility | | $6,303.00 | $20,071.20 | $32,779.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,509.48 / $36,459.64 / $48,920.97
| Facility | | $26,509.48 | $36,459.64 | $48,920.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,719.88 / $29,827.17 / $41,812.79
| Facility | | $21,719.88 | $29,827.17 | $41,812.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,909.12 / $33,126.41 / $41,761.58
| Facility | | $18,909.12 | $33,126.41 | $41,761.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,909.12 / $33,402.17 / $43,800.22
| Facility | | $18,909.12 | $33,402.17 | $43,800.22 |