- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $27,857.40 / $45,495.90
| Facility | | $6,303.00 | $27,857.40 | $45,495.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,793.23 / $50,603.32 / $67,898.73
| Facility | | $36,793.23 | $50,603.32 | $67,898.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,145.61 / $41,397.93 / $58,033.11
| Facility | | $30,145.61 | $41,397.93 | $58,033.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,244.48 / $45,977.05 / $57,962.03
| Facility | | $26,244.48 | $45,977.05 | $57,962.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,244.48 / $46,359.78 / $60,791.51
| Facility | | $26,244.48 | $46,359.78 | $60,791.51 |