- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $48,955.80 / $79,953.20
| Facility | | $6,303.00 | $48,955.80 | $79,953.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,659.34 / $88,928.79 / $119,323.25
| Facility | | $64,659.34 | $88,928.79 | $119,323.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,977.02 / $72,751.50 / $101,985.68
| Facility | | $52,977.02 | $72,751.50 | $101,985.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,121.28 / $80,798.72 / $101,860.77
| Facility | | $46,121.28 | $80,798.72 | $101,860.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,121.28 / $81,471.32 / $106,833.22
| Facility | | $46,121.28 | $81,471.32 | $106,833.22 |