- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $26,417.60 / $43,144.40
| Facility | | $6,303.00 | $26,417.60 | $43,144.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,891.51 / $47,987.82 / $64,389.30
| Facility | | $34,891.51 | $47,987.82 | $64,389.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,587.50 / $39,258.23 / $55,033.59
| Facility | | $28,587.50 | $39,258.23 | $55,033.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,888.00 / $43,600.67 / $54,966.19
| Facility | | $24,888.00 | $43,600.67 | $54,966.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,888.00 / $43,963.62 / $57,649.42
| Facility | | $24,888.00 | $43,963.62 | $57,649.42 |