- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,383.09 / $33,289.00
| Facility | | $6,303.00 | $20,383.09 | $33,289.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,921.32 / $37,026.05 / $49,680.97
| Facility | | $26,921.32 | $37,026.05 | $49,680.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,057.31 / $30,290.54 / $42,462.37
| Facility | | $22,057.31 | $30,290.54 | $42,462.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,202.88 / $33,641.05 / $42,410.36
| Facility | | $19,202.88 | $33,641.05 | $42,410.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,202.88 / $33,921.08 / $44,480.67
| Facility | | $19,202.88 | $33,921.08 | $44,480.67 |