- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $22,811.30 / $37,254.80
| Facility | | $6,303.00 | $22,811.30 | $37,254.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,128.51 / $41,437.05 / $55,599.57
| Facility | | $30,128.51 | $41,437.05 | $55,599.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,685.04 / $33,899.12 / $47,521.00
| Facility | | $24,685.04 | $33,899.12 | $47,521.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,490.56 / $37,648.76 / $47,462.80
| Facility | | $21,490.56 | $37,648.76 | $47,462.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,490.56 / $37,962.18 / $49,779.75
| Facility | | $21,490.56 | $37,962.18 | $49,779.75 |