- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,794.09 / $32,327.10
| Facility | | $6,303.00 | $19,794.09 | $32,327.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,143.41 / $35,956.16 / $48,245.41
| Facility | | $26,143.41 | $35,956.16 | $48,245.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,419.95 / $29,415.28 / $41,235.39
| Facility | | $21,419.95 | $29,415.28 | $41,235.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,648.00 / $32,668.97 / $41,184.89
| Facility | | $18,648.00 | $32,668.97 | $41,184.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,648.00 / $32,940.92 / $43,195.37
| Facility | | $18,648.00 | $32,940.92 | $43,195.37 |