- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,270.60 / $34,738.50
| Facility | | $6,303.00 | $21,270.60 | $34,738.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,093.57 / $38,638.30 / $51,844.25
| Facility | | $28,093.57 | $38,638.30 | $51,844.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,017.76 / $31,609.50 / $44,311.33
| Facility | | $23,017.76 | $31,609.50 | $44,311.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,039.04 / $35,105.89 / $44,257.05
| Facility | | $20,039.04 | $35,105.89 | $44,257.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,039.04 / $35,398.12 / $46,417.51
| Facility | | $20,039.04 | $35,398.12 | $46,417.51 |