- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,145.00 / $50,804.10 / $53,697.50
| Facility | | $4,145.00 | $50,804.10 | $53,697.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $46,893.56 / $125,571.77
| Facility | | $5,840.42 | $46,893.56 | $125,571.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,014.76 / $50,014.09 / $72,493.11
| Facility | | $29,014.76 | $50,014.09 | $72,493.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $68,131.61 / $68,131.61 / $68,131.61
| Facility | | $68,131.61 | $68,131.61 | $68,131.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,804.58 / $48,332.03 / $74,636.00
| Facility | | $41,804.58 | $48,332.03 | $74,636.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $46,893.56 / $125,571.77
| Facility | | $5,840.42 | $46,893.56 | $125,571.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $46,893.56 / $98,135.45
| Facility | | $5,840.42 | $46,893.56 | $98,135.45 |