- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $22,334.40 / $36,475.90
| Facility | | $6,303.00 | $22,334.40 | $36,475.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,498.65 / $40,570.76 / $54,437.21
| Facility | | $29,498.65 | $40,570.76 | $54,437.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,168.98 / $33,190.43 / $46,527.53
| Facility | | $24,168.98 | $33,190.43 | $46,527.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,041.28 / $36,861.69 / $46,470.54
| Facility | | $21,041.28 | $36,861.69 | $46,470.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,041.28 / $37,168.54 / $48,739.06
| Facility | | $21,041.28 | $37,168.54 | $48,739.06 |