- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $31,805.00 / $51,943.00
| Facility | | $6,303.00 | $31,805.00 | $51,943.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,007.11 / $57,774.19 / $77,520.50
| Facility | | $42,007.11 | $57,774.19 | $77,520.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,417.47 / $47,264.33 / $66,256.83
| Facility | | $34,417.47 | $47,264.33 | $66,256.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,963.52 / $52,492.34 / $66,175.67
| Facility | | $29,963.52 | $52,492.34 | $66,175.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,963.52 / $52,929.31 / $69,406.12
| Facility | | $29,963.52 | $52,929.31 | $69,406.12 |