- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $69,621.20 / $115,572.00
| Facility | | $3,822.00 | $69,621.20 | $115,572.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $63,578.47 / $170,250.71
| Facility | | $5,840.42 | $63,578.47 | $170,250.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,338.32 / $66,374.00 / $99,531.60
| Facility | | $39,338.32 | $66,374.00 | $99,531.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92,373.10 / $92,373.10 / $92,373.10
| Facility | | $92,373.10 | $92,373.10 | $92,373.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,678.83 / $65,528.76 / $101,191.79
| Facility | | $56,678.83 | $65,528.76 | $101,191.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $63,578.47 / $170,250.71
| Facility | | $5,840.42 | $63,578.47 | $170,250.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $63,578.47 / $133,052.44
| Facility | | $5,840.42 | $63,578.47 | $133,052.44 |