- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $78,730.00 / $133,301.00
| Facility | | $3,821.00 | $78,730.00 | $133,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,045.60 / $106,335.89 / $179,852.82
| Facility | | $39,045.60 | $106,335.89 | $179,852.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77,555.66 / $107,006.43 / $179,104.60
| Facility | | $77,555.66 | $107,006.43 | $179,104.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91,764.89 / $119,420.60 / $174,363.81
| Facility | | $91,764.89 | $119,420.60 | $174,363.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $91,764.89 / $111,017.37 / $174,363.81
| Facility | | $91,764.89 | $111,017.37 | $174,363.81 |