- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,884.42 / $89,125.09 / $165,958.69
| Facility | | $33,884.42 | $89,125.09 | $165,958.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $77,624.71 / $134,896.29 / $173,780.08
| Facility | | $77,624.71 | $134,896.29 | $173,780.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $117,489.76 / $151,356.12
| Facility | | $75,857.76 | $117,489.76 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,884.37 / $104,712.85 / $263,026.80
| Facility | | $58,884.37 | $104,712.85 | $263,026.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $91,201.08 / $154,881.66
| Facility | | $10,000.00 | $91,201.08 | $154,881.66 |