- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,016.20 / $32,689.90
| Facility | | $6,303.00 | $20,016.20 | $32,689.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,436.81 / $36,359.68 / $48,786.85
| Facility | | $26,436.81 | $36,359.68 | $48,786.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,660.34 / $29,745.39 / $41,698.16
| Facility | | $21,660.34 | $29,745.39 | $41,698.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,857.28 / $33,035.60 / $41,647.08
| Facility | | $18,857.28 | $33,035.60 | $41,647.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,857.28 / $33,310.60 / $43,680.14
| Facility | | $18,857.28 | $33,310.60 | $43,680.14 |