- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $72,771.00 / $155,662.00
| Facility | | $3,821.00 | $72,771.00 | $155,662.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,753.01 / $124,602.71 / $210,748.69
| Facility | | $45,753.01 | $124,602.71 | $210,748.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $76,850.00 / $119,013.65 / $209,149.21
| Facility | | $76,850.00 | $119,013.65 | $209,149.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107,158.35 / $139,453.28 / $203,613.16
| Facility | | $107,158.35 | $139,453.28 | $203,613.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107,158.35 / $129,640.42 / $203,613.16
| Facility | | $107,158.35 | $129,640.42 | $203,613.16 |