- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $20,662.30 / $33,745.00
| Facility | | $6,303.00 | $20,662.30 | $33,745.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,290.08 / $37,533.23 / $50,361.50
| Facility | | $27,290.08 | $37,533.23 | $50,361.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,359.45 / $30,705.46 / $43,044.02
| Facility | | $22,359.45 | $30,705.46 | $43,044.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,465.91 / $34,101.86 / $42,991.30
| Facility | | $19,465.91 | $34,101.86 | $42,991.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,465.91 / $34,385.74 / $45,089.96
| Facility | | $19,465.91 | $34,385.74 | $45,089.96 |