- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $25,891.80 / $42,285.70
| Facility | | $6,303.00 | $25,891.80 | $42,285.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,197.06 / $47,032.69 / $63,107.72
| Facility | | $34,197.06 | $47,032.69 | $63,107.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,018.50 / $38,476.85 / $53,938.23
| Facility | | $28,018.50 | $38,476.85 | $53,938.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,392.64 / $42,732.86 / $53,872.16
| Facility | | $24,392.64 | $42,732.86 | $53,872.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,392.64 / $43,088.58 / $56,501.99
| Facility | | $24,392.64 | $43,088.58 | $56,501.99 |