- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,671.10 / $35,392.50
| Facility | | $6,303.00 | $21,671.10 | $35,392.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,622.49 / $39,365.75 / $52,820.34
| Facility | | $28,622.49 | $39,365.75 | $52,820.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,451.12 / $32,204.62 / $45,145.59
| Facility | | $23,451.12 | $32,204.62 | $45,145.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,416.32 / $35,766.83 / $45,090.29
| Facility | | $20,416.32 | $35,766.83 | $45,090.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,416.32 / $36,064.58 / $47,291.43
| Facility | | $20,416.32 | $36,064.58 | $47,291.43 |