- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,360.59 / $33,252.40
| Facility | | $6,303.00 | $20,360.59 | $33,252.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,891.71 / $36,985.33 / $49,626.33
| Facility | | $26,891.71 | $36,985.33 | $49,626.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,033.05 / $30,257.23 / $42,415.67
| Facility | | $22,033.05 | $30,257.23 | $42,415.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,181.75 / $33,604.05 / $42,363.72
| Facility | | $19,181.75 | $33,604.05 | $42,363.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,181.75 / $33,883.78 / $44,431.75
| Facility | | $19,181.75 | $33,883.78 | $44,431.75 |