- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $41,686.94 / $67,608.30
| Facility | | $27,542.29 | $41,686.94 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $27,542.29 / $48,977.88
| Facility | | $13,182.57 | $27,542.29 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $44,668.36 / $81,283.05
| Facility | | $25,703.96 | $44,668.36 | $81,283.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102,329.30 / $102,329.30 / $102,329.30
| Facility | | $102,329.30 | $102,329.30 | $102,329.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $38,018.94 / $67,608.30
| Facility | | $15,848.93 | $38,018.94 | $67,608.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $36,307.81 / $87,096.36
| Facility | | $25,703.96 | $36,307.81 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $34,673.69 / $79,432.82
| Facility | | $7,079.46 | $34,673.69 | $79,432.82 |