- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $65,569.60 / $107,086.00
| Facility | | $6,303.00 | $65,569.60 | $107,086.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86,602.31 / $119,107.91 / $159,817.10
| Facility | | $86,602.31 | $119,107.91 | $159,817.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70,955.44 / $97,440.66 / $136,595.81
| Facility | | $70,955.44 | $97,440.66 | $136,595.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,773.12 / $108,218.78 / $136,428.51
| Facility | | $61,773.12 | $108,218.78 | $136,428.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,773.12 / $109,119.64 / $143,088.42
| Facility | | $61,773.12 | $109,119.64 | $143,088.42 |