- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,777.80 / $42,324.90 / $92,782.20
| Facility | | $26,777.80 | $42,324.90 | $92,782.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,781.12 / $39,626.50 / $65,553.10
| Facility | | $26,781.12 | $39,626.50 | $65,553.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,596.22 / $47,794.57 / $65,578.39
| Facility | | $27,596.22 | $47,794.57 | $65,578.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $94,976.00 / $94,976.00 / $111,462.40
| Facility | | $94,976.00 | $94,976.00 | $111,462.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,520.00 / $41,872.71 / $65,283.16
| Facility | | $2,520.00 | $41,872.71 | $65,283.16 |