- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,333.00 / $44,786.40 / $69,007.20
| Facility | | $3,333.00 | $44,786.40 | $69,007.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,169.70 / $45,647.25 / $68,392.50
| Facility | | $28,169.70 | $45,647.25 | $68,392.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,020.50 / $45,586.78 / $82,510.00
| Facility | | $33,020.50 | $45,586.78 | $82,510.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $247.53 / $483.47 / $770.52
| Facility | | $247.53 | $483.47 | $770.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,378.00 / $49,373.98 / $79,795.42
| Facility | | $32,378.00 | $49,373.98 | $79,795.42 |