- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $17,206.00 / $90,730.10
| Facility | | $2,120.00 | $17,206.00 | $90,730.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,868.53 / $39,868.53 / $39,868.53
| Facility | | $39,868.53 | $39,868.53 | $39,868.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,107.14 / $55,573.20 / $100,638.91
| Facility | | $34,107.14 | $55,573.20 | $100,638.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,624.34 / $101,993.89 / $156,994.85
| Facility | | $56,624.34 | $101,993.89 | $156,994.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,190.00 / $113,160.19 / $174,922.26
| Facility | | $42,190.00 | $113,160.19 | $174,922.26 |