- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $25,052.10 / $40,914.40
| Facility | | $6,303.00 | $25,052.10 | $40,914.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,088.07 / $45,507.45 / $61,061.17
| Facility | | $33,088.07 | $45,507.45 | $61,061.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,109.88 / $37,229.07 / $52,189.04
| Facility | | $27,109.88 | $37,229.07 | $52,189.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,601.60 / $41,347.05 / $52,125.12
| Facility | | $23,601.60 | $41,347.05 | $52,125.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,601.60 / $41,691.24 / $54,669.66
| Facility | | $23,601.60 | $41,691.24 | $54,669.66 |