- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,872.10 / $50,429.00 / $88,740.50
| Facility | | $29,872.10 | $50,429.00 | $88,740.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,041.32 / $30,463.10 / $50,515.36
| Facility | | $21,041.32 | $30,463.10 | $50,515.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,173.35 / $45,712.60 / $62,721.75
| Facility | | $27,173.35 | $45,712.60 | $62,721.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104,346.40 / $104,346.40 / $122,459.36
| Facility | | $104,346.40 | $104,346.40 | $122,459.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $43,948.48 / $62,775.37
| Facility | | $1,787.00 | $43,948.48 | $62,775.37 |