- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,706.60 / $58,590.50 / $103,102.00
| Facility | | $34,706.60 | $58,590.50 | $103,102.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,767.13 / $39,831.90 / $64,983.78
| Facility | | $26,767.13 | $39,831.90 | $64,983.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,571.11 / $53,110.77 / $72,872.69
| Facility | | $31,571.11 | $53,110.77 | $72,872.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107,786.10 / $107,786.10 / $126,496.14
| Facility | | $107,786.10 | $107,786.10 | $126,496.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $51,061.14 / $72,934.99
| Facility | | $1,787.00 | $51,061.14 | $72,934.99 |