- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $93,376.00 / $198,327.00
| Facility | | $3,821.00 | $93,376.00 | $198,327.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,960.44 / $144,231.23 / $243,947.70
| Facility | | $52,960.44 | $144,231.23 | $243,947.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110,261.94 / $159,205.29 / $266,473.69
| Facility | | $110,261.94 | $159,205.29 | $266,473.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136,528.76 / $177,675.21 / $259,420.29
| Facility | | $136,528.76 | $177,675.21 | $259,420.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $136,528.76 / $165,172.79 / $259,420.29
| Facility | | $136,528.76 | $165,172.79 | $259,420.29 |