- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,657.50 / $32,104.10
| Facility | | $6,303.00 | $19,657.50 | $32,104.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,963.06 / $35,708.12 / $47,912.59
| Facility | | $25,963.06 | $35,708.12 | $47,912.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,272.19 / $29,212.36 / $40,950.93
| Facility | | $21,272.19 | $29,212.36 | $40,950.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,519.36 / $32,443.60 / $40,900.78
| Facility | | $18,519.36 | $32,443.60 | $40,900.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,519.36 / $32,713.68 / $42,897.40
| Facility | | $18,519.36 | $32,713.68 | $42,897.40 |