- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,698.00 / $56,850.00 / $138,142.00
| Facility | | $5,698.00 | $56,850.00 | $138,142.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,717.58 / $38,913.08 / $49,325.18
| Facility | | $21,717.58 | $38,913.08 | $49,325.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,082.11 / $39,807.21 / $72,179.67
| Facility | | $19,082.11 | $39,807.21 | $72,179.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,942.00 / $57,970.41 / $88,854.38
| Facility | | $19,942.00 | $57,970.41 | $88,854.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,891.00 / $64,896.69 / $99,000.74
| Facility | | $24,891.00 | $64,896.69 | $99,000.74 |