- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,058.40 / $31,125.50
| Facility | | $6,303.00 | $19,058.40 | $31,125.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,171.69 / $34,619.72 / $46,452.19
| Facility | | $25,171.69 | $34,619.72 | $46,452.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,623.80 / $28,321.95 / $39,702.73
| Facility | | $20,623.80 | $28,321.95 | $39,702.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,954.88 / $31,454.71 / $39,654.10
| Facility | | $17,954.88 | $31,454.71 | $39,654.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,954.88 / $31,716.55 / $41,589.86
| Facility | | $17,954.88 | $31,716.55 | $41,589.86 |