- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,233.90 / $34,678.60
| Facility | | $6,303.00 | $21,233.90 | $34,678.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,045.11 / $38,571.66 / $51,754.84
| Facility | | $28,045.11 | $38,571.66 | $51,754.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,978.06 / $31,554.98 / $44,234.91
| Facility | | $22,978.06 | $31,554.98 | $44,234.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,004.48 / $35,045.35 / $44,180.73
| Facility | | $20,004.48 | $35,045.35 | $44,180.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,004.48 / $35,337.08 / $46,337.46
| Facility | | $20,004.48 | $35,337.08 | $46,337.46 |