- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,973.00 / $23,025.50 / $42,072.60
| Facility | | $1,973.00 | $23,025.50 | $42,072.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,425.97 / $14,776.96 / $24,993.24
| Facility | | $5,425.97 | $14,776.96 | $24,993.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,521.74 / $39,698.41 / $63,099.50
| Facility | | $24,521.74 | $39,698.41 | $63,099.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,962.89 / $37,691.60 / $55,032.81
| Facility | | $28,962.89 | $37,691.60 | $55,032.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,204.83 / $32,961.99 / $51,380.28
| Facility | | $19,204.83 | $32,961.99 | $51,380.28 |