- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $25,271.90 / $63,699.80
| Facility | | $3,821.00 | $25,271.90 | $63,699.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,717.85 / $40,082.26 / $67,793.74
| Facility | | $14,717.85 | $40,082.26 | $67,793.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,414.61 / $51,134.54 / $85,587.66
| Facility | | $35,414.61 | $51,134.54 | $85,587.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,851.15 / $57,066.82 / $83,322.21
| Facility | | $43,851.15 | $57,066.82 | $83,322.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,851.15 / $53,051.22 / $83,322.21
| Facility | | $43,851.15 | $53,051.22 | $83,322.21 |