- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $23,086.50 / $37,704.10
| Facility | | $6,303.00 | $23,086.50 | $37,704.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,491.89 / $41,936.82 / $56,270.16
| Facility | | $30,491.89 | $41,936.82 | $56,270.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,982.77 / $34,307.98 / $48,094.16
| Facility | | $24,982.77 | $34,307.98 | $48,094.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,749.76 / $38,102.86 / $48,035.25
| Facility | | $21,749.76 | $38,102.86 | $48,035.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,749.76 / $38,420.04 / $50,380.15
| Facility | | $21,749.76 | $38,420.04 | $50,380.15 |