- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,145.00 / $49,807.70 / $65,031.00
| Facility | | $4,145.00 | $49,807.70 | $65,031.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,324.00 / $121,798.93
| Facility | | $5,840.42 | $45,324.00 | $121,798.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,139.29 / $44,223.47 / $66,968.98
| Facility | | $17,139.29 | $44,223.47 | $66,968.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66,084.57 / $66,084.57 / $66,084.57
| Facility | | $66,084.57 | $66,084.57 | $66,084.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,548.56 / $46,879.88 / $72,393.55
| Facility | | $40,548.56 | $46,879.88 | $72,393.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,324.00 / $121,798.93
| Facility | | $5,840.42 | $45,324.00 | $121,798.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,324.00 / $95,186.95
| Facility | | $5,840.42 | $45,324.00 | $95,186.95 |