- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $26,162.30 / $65,944.00
| Facility | | $3,821.00 | $26,162.30 | $65,944.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,378.21 / $30,987.17 / $52,410.62
| Facility | | $11,378.21 | $30,987.17 | $52,410.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,662.31 / $52,936.07 / $88,603.02
| Facility | | $36,662.31 | $52,936.07 | $88,603.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,396.08 / $59,077.35 / $86,257.75
| Facility | | $45,396.08 | $59,077.35 | $86,257.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,396.08 / $54,920.28 / $86,257.75
| Facility | | $45,396.08 | $54,920.28 | $86,257.75 |