- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $32,200.40 / $52,588.70
| Facility | | $6,303.00 | $32,200.40 | $52,588.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,529.30 / $58,492.39 / $78,484.16
| Facility | | $42,529.30 | $58,492.39 | $78,484.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,845.32 / $47,851.88 / $67,080.48
| Facility | | $34,845.32 | $47,851.88 | $67,080.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,336.00 / $53,144.88 / $66,998.32
| Facility | | $30,336.00 | $53,144.88 | $66,998.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,336.00 / $53,587.28 / $70,268.92
| Facility | | $30,336.00 | $53,587.28 | $70,268.92 |