- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,120.00 / $17,206.00 / $50,027.60
| Facility | | $2,120.00 | $17,206.00 | $50,027.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,868.61 / $20,868.61 / $20,868.61
| Facility | | $20,868.61 | $20,868.61 | $20,868.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,071.85 / $49,173.17 / $87,823.75
| Facility | | $30,071.85 | $49,173.17 | $87,823.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,353.83 / $58,623.84 / $86,565.23
| Facility | | $41,353.83 | $58,623.84 | $86,565.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,971.00 / $73,075.28 / $117,385.44
| Facility | | $36,971.00 | $73,075.28 | $117,385.44 |