- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $19,508.80 / $31,861.10
| Facility | | $6,303.00 | $19,508.80 | $31,861.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,766.57 / $35,437.87 / $47,549.98
| Facility | | $25,766.57 | $35,437.87 | $47,549.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,111.19 / $28,991.27 / $40,641.01
| Facility | | $21,111.19 | $28,991.27 | $40,641.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,379.20 / $32,198.06 / $40,591.23
| Facility | | $18,379.20 | $32,198.06 | $40,591.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,379.20 / $32,466.09 / $42,572.74
| Facility | | $18,379.20 | $32,466.09 | $42,572.74 |