- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $31,196.70 / $50,949.50
| Facility | | $6,303.00 | $31,196.70 | $50,949.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,203.62 / $56,669.13 / $76,037.74
| Facility | | $41,203.62 | $56,669.13 | $76,037.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,759.16 / $46,360.29 / $64,989.52
| Facility | | $33,759.16 | $46,360.29 | $64,989.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,390.40 / $51,488.31 / $64,909.92
| Facility | | $29,390.40 | $51,488.31 | $64,909.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,390.40 / $51,916.92 / $68,078.58
| Facility | | $29,390.40 | $51,916.92 | $68,078.58 |