- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $77,624.71 / $128,824.96
| Facility | | $26,915.35 | $77,624.71 | $128,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $109,647.82 / $128,824.96
| Facility | | $46,773.51 | $109,647.82 | $128,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $75,857.76 / $125,892.54
| Facility | | $100.00 | $75,857.76 | $125,892.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $72,443.60 / $117,489.76
| Facility | | $48,977.88 | $72,443.60 | $117,489.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128,824.96 / $128,824.96 / $128,824.96
| Facility | | $128,824.96 | $128,824.96 | $128,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $48,977.88 / $81,283.05 / $141,253.75
| Facility | | $48,977.88 | $81,283.05 | $141,253.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70,794.58 / $70,794.58 / $70,794.58
| Facility | | $70,794.58 | $70,794.58 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,317.64 / $61,659.50 / $114,815.36
| Facility | | $8,317.64 | $61,659.50 | $114,815.36 |