- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $104,233.00 / $136,091.00
| Facility | | $3,822.00 | $104,233.00 | $136,091.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $93,956.66 / $254,889.68
| Facility | | $5,840.42 | $93,956.66 | $254,889.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,895.10 / $97,384.32 / $147,148.88
| Facility | | $58,895.10 | $97,384.32 | $147,148.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138,295.76 / $138,295.76 / $138,295.76
| Facility | | $138,295.76 | $138,295.76 | $138,295.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $84,856.32 / $98,105.93 / $151,498.59
| Facility | | $84,856.32 | $98,105.93 | $151,498.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $93,956.66 / $254,889.68
| Facility | | $5,840.42 | $93,956.66 | $254,889.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $95,186.07 / $199,198.54
| Facility | | $5,840.42 | $95,186.07 | $199,198.54 |