- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,767.00 / $72,593.10 / $108,621.00
| Facility | | $5,767.00 | $72,593.10 | $108,621.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,698.95 / $72,781.14 / $123,099.50
| Facility | | $26,698.95 | $72,781.14 | $123,099.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,323.28 / $73,251.69 / $130,660.34
| Facility | | $52,323.28 | $73,251.69 | $130,660.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,529.86 / $81,374.84 / $118,813.90
| Facility | | $62,529.86 | $81,374.84 | $118,813.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,529.86 / $75,648.75 / $118,813.90
| Facility | | $62,529.86 | $75,648.75 | $118,813.90 |