- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $29,408.30 / $48,028.80
| Facility | | $6,303.00 | $29,408.30 | $48,028.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,841.64 / $53,420.58 / $71,678.89
| Facility | | $38,841.64 | $53,420.58 | $71,678.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,823.92 / $43,702.70 / $61,264.01
| Facility | | $31,823.92 | $43,702.70 | $61,264.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,705.60 / $48,536.75 / $61,188.97
| Facility | | $27,705.60 | $48,536.75 | $61,188.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,705.60 / $48,940.79 / $64,175.98
| Facility | | $27,705.60 | $48,940.79 | $64,175.98 |