- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,254.30 / $34,711.90
| Facility | | $6,303.00 | $21,254.30 | $34,711.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,072.03 / $38,608.68 / $51,804.51
| Facility | | $28,072.03 | $38,608.68 | $51,804.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,000.12 / $31,585.27 / $44,277.36
| Facility | | $23,000.12 | $31,585.27 | $44,277.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,023.68 / $35,078.98 / $44,223.13
| Facility | | $20,023.68 | $35,078.98 | $44,223.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,023.68 / $35,371.00 / $46,381.93
| Facility | | $20,023.68 | $35,371.00 | $46,381.93 |