- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $22,798.10 / $37,233.10
| Facility | | $6,303.00 | $22,798.10 | $37,233.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,111.02 / $41,412.98 / $55,567.28
| Facility | | $30,111.02 | $41,412.98 | $55,567.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,670.71 / $33,879.43 / $47,493.40
| Facility | | $24,670.71 | $33,879.43 | $47,493.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,478.08 / $37,626.91 / $47,435.23
| Facility | | $21,478.08 | $37,626.91 | $47,435.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,478.08 / $37,940.12 / $49,750.84
| Facility | | $21,478.08 | $37,940.12 | $49,750.84 |