- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $72,307.89 / $93,376.00
| Facility | | $3,821.00 | $72,307.89 | $93,376.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,711.56 / $91,809.29 / $155,283.04
| Facility | | $33,711.56 | $91,809.29 | $155,283.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,117.75 / $72,963.95 / $130,147.09
| Facility | | $52,117.75 | $72,963.95 | $130,147.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,284.23 / $81,055.19 / $118,347.18
| Facility | | $62,284.23 | $81,055.19 | $118,347.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,284.23 / $75,351.60 / $118,347.18
| Facility | | $62,284.23 | $75,351.60 | $118,347.18 |