- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,821.00 / $25,821.20 / $65,084.40
| Facility | | $3,821.00 | $25,821.20 | $65,084.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,139.01 / $33,059.11 / $55,915.03
| Facility | | $12,139.01 | $33,059.11 | $55,915.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,491.05 / $52,486.83 / $93,621.68
| Facility | | $37,491.05 | $52,486.83 | $93,621.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,804.34 / $58,307.28 / $85,133.39
| Facility | | $44,804.34 | $58,307.28 | $85,133.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,804.34 / $54,204.39 / $85,133.39
| Facility | | $44,804.34 | $54,204.39 | $85,133.39 |