- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $21,329.70 / $34,835.00
| Facility | | $6,303.00 | $21,329.70 | $34,835.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,171.63 / $38,745.66 / $51,988.31
| Facility | | $28,171.63 | $38,745.66 | $51,988.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,081.72 / $31,697.33 / $44,434.45
| Facility | | $23,081.72 | $31,697.33 | $44,434.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,094.72 / $35,203.44 / $44,380.03
| Facility | | $20,094.72 | $35,203.44 | $44,380.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,094.72 / $35,496.49 / $46,546.49
| Facility | | $20,094.72 | $35,496.49 | $46,546.49 |