- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $65,092.60 / $103,301.00
| Facility | | $3,822.00 | $65,092.60 | $103,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $59,442.86 / $159,176.34
| Facility | | $5,840.42 | $59,442.86 | $159,176.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,779.47 / $60,815.65 / $91,893.17
| Facility | | $36,779.47 | $60,815.65 | $91,893.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $86,364.47 / $86,364.47 / $86,364.47
| Facility | | $86,364.47 | $86,364.47 | $86,364.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,992.02 / $61,266.29 / $94,609.53
| Facility | | $52,992.02 | $61,266.29 | $94,609.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $59,442.86 / $159,176.34
| Facility | | $5,840.42 | $59,442.86 | $159,176.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $59,442.86 / $124,397.72
| Facility | | $5,840.42 | $59,442.86 | $124,397.72 |