- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $67,866.89 / $93,386.00
| Facility | | $3,821.00 | $67,866.89 | $93,386.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,441.27 / $69,850.27 / $117,188.23
| Facility | | $25,441.27 | $69,850.27 | $117,188.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,211.96 / $68,168.53 / $114,098.72
| Facility | | $47,211.96 | $68,168.53 | $114,098.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,458.89 / $76,076.99 / $111,078.60
| Facility | | $58,458.89 | $76,076.99 | $111,078.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,763.16 / $64,964.10 / $103,706.31
| Facility | | $38,763.16 | $64,964.10 | $103,706.31 |