- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,075.00 / $53,569.60 / $81,107.70
| Facility | | $20,075.00 | $53,569.60 | $81,107.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,977.33 / $53,437.71 / $80,064.82
| Facility | | $32,977.33 | $53,437.71 | $80,064.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,648.91 / $51,517.40 / $96,574.00
| Facility | | $38,648.91 | $51,517.40 | $96,574.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $289.72 / $550.80 / $901.86
| Facility | | $289.72 | $550.80 | $901.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,871.49 / $57,789.88 / $93,396.72
| Facility | | $37,871.49 | $57,789.88 | $93,396.72 |