- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $72,701.60 / $118,734.00
| Facility | | $6,303.00 | $72,701.60 | $118,734.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93,562.86 / $132,063.23 / $177,200.35
| Facility | | $93,562.86 | $132,063.23 | $177,200.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $78,673.23 / $108,039.25 / $151,453.29
| Facility | | $78,673.23 | $108,039.25 | $151,453.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68,492.16 / $119,989.70 / $151,267.79
| Facility | | $68,492.16 | $119,989.70 | $151,267.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68,492.16 / $120,988.55 / $158,652.10
| Facility | | $68,492.16 | $120,988.55 | $158,652.10 |