- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $26,475.10 / $66,732.60
| Facility | | $3,821.00 | $26,475.10 | $66,732.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,078.44 / $46,078.44 / $46,078.44
| Facility | | $46,078.44 | $46,078.44 | $46,078.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,142.80 / $38,516.16 / $65,144.90
| Facility | | $14,142.80 | $38,516.16 | $65,144.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,100.75 / $53,569.13 / $89,662.62
| Facility | | $37,100.75 | $53,569.13 | $89,662.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,938.97 / $59,783.86 / $87,289.30
| Facility | | $45,938.97 | $59,783.86 | $87,289.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,938.97 / $55,577.06 / $87,289.30
| Facility | | $45,938.97 | $55,577.06 | $87,289.30 |