- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,656.00 / $53,769.10 / $127,758.00
| Facility | | $5,656.00 | $53,769.10 | $127,758.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,896.48 / $21,896.48 / $21,896.48
| Facility | | $21,896.48 | $21,896.48 | $21,896.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,592.00 / $66,220.09 / $109,204.84
| Facility | | $38,592.00 | $66,220.09 | $109,204.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,078.14 / $68,005.47 / $127,215.52
| Facility | | $38,078.14 | $68,005.47 | $127,215.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,763.20 / $80,892.00 / $109,862.16
| Facility | | $51,763.20 | $80,892.00 | $109,862.16 |