- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,822.00 / $49,715.60 / $64,910.80
| Facility | | $3,822.00 | $49,715.60 | $64,910.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,400.58 / $121,573.86
| Facility | | $5,840.42 | $45,400.58 | $121,573.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,090.99 / $46,449.07 / $70,185.10
| Facility | | $28,090.99 | $46,449.07 | $70,185.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $65,962.46 / $65,962.46 / $65,962.46
| Facility | | $65,962.46 | $65,962.46 | $65,962.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,473.62 / $46,793.25 / $72,259.77
| Facility | | $40,473.62 | $46,793.25 | $72,259.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,400.58 / $121,573.86
| Facility | | $5,840.42 | $45,400.58 | $121,573.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,840.42 / $45,400.58 / $95,011.05
| Facility | | $5,840.42 | $45,400.58 | $95,011.05 |