- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,652.00 / $46,721.30 / $102,420.00
| Facility | | $15,652.00 | $46,721.30 | $102,420.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,040.32 / $45,818.55 / $75,758.41
| Facility | | $31,040.32 | $45,818.55 | $75,758.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,362.05 / $52,759.08 / $72,390.14
| Facility | | $31,362.05 | $52,759.08 | $72,390.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $103,622.95 / $103,622.95 / $121,610.33
| Facility | | $103,622.95 | $103,622.95 | $121,610.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $47,430.87 / $72,064.23
| Facility | | $2,520.00 | $47,430.87 | $72,064.23 |