- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,300.00 / $51,151.40 / $90,011.60
| Facility | | $30,300.00 | $51,151.40 | $90,011.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,239.50 / $53,621.54 / $88,447.77
| Facility | | $36,239.50 | $53,621.54 | $88,447.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,562.57 / $46,367.37 / $63,620.16
| Facility | | $27,562.57 | $46,367.37 | $63,620.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $93,295.90 / $93,295.90 / $109,490.66
| Facility | | $93,295.90 | $93,295.90 | $109,490.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $40,622.33 / $63,333.73
| Facility | | $2,520.00 | $40,622.33 | $63,333.73 |