- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,568.20 / $35,224.50
| Facility | | $6,303.00 | $21,568.20 | $35,224.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,486.56 / $39,178.80 / $52,569.49
| Facility | | $28,486.56 | $39,178.80 | $52,569.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,339.75 / $32,051.67 / $44,931.18
| Facility | | $23,339.75 | $32,051.67 | $44,931.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,319.36 / $35,596.98 / $44,876.15
| Facility | | $20,319.36 | $35,596.98 | $44,876.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,319.36 / $35,893.30 / $47,066.83
| Facility | | $20,319.36 | $35,893.30 | $47,066.83 |