- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $45,959.20 / $60,006.20
| Facility | | $3,822.00 | $45,959.20 | $60,006.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,970.14 / $112,387.82
| Facility | | $5,840.42 | $41,970.14 | $112,387.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,968.46 / $42,939.41 / $64,881.96
| Facility | | $25,968.46 | $42,939.41 | $64,881.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,978.38 / $60,978.38 / $60,978.38
| Facility | | $60,978.38 | $60,978.38 | $60,978.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,415.47 / $43,257.59 / $66,799.87
| Facility | | $37,415.47 | $43,257.59 | $66,799.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,970.14 / $112,387.82
| Facility | | $5,840.42 | $41,970.14 | $112,387.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $41,970.14 / $87,832.08
| Facility | | $5,840.42 | $41,970.14 | $87,832.08 |