- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,327.00 / $33,197.50
| Facility | | $6,303.00 | $20,327.00 | $33,197.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,847.30 / $36,924.25 / $49,544.37
| Facility | | $26,847.30 | $36,924.25 | $49,544.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,996.66 / $30,207.26 / $42,345.61
| Facility | | $21,996.66 | $30,207.26 | $42,345.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,150.08 / $33,548.55 / $42,293.75
| Facility | | $19,150.08 | $33,548.55 | $42,293.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,150.08 / $33,827.82 / $44,358.37
| Facility | | $19,150.08 | $33,827.82 | $44,358.37 |