- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,731.00 / $31,936.90 / $49,307.80
| Facility | | $21,731.00 | $31,936.90 | $49,307.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,775.21 / $40,908.26 / $52,446.49
| Facility | | $28,775.21 | $40,908.26 | $52,446.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,457.44 / $45,619.54 / $56,649.78
| Facility | | $24,457.44 | $45,619.54 | $56,649.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,731.00 / $32,665.90 / $52,234.20
| Facility | | $21,731.00 | $32,665.90 | $52,234.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,600.86 / $43,458.46 / $66,026.03
| Facility | | $28,600.86 | $43,458.46 | $66,026.03 |