- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,183.10 / $69,183.10 / $69,183.10
| Facility | | $69,183.10 | $69,183.10 | $69,183.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,176.38 / $138,038.43 / $218,776.16
| Facility | | $83,176.38 | $138,038.43 | $218,776.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208,929.61 / $275,422.87 / $288,403.15
| Facility | | $208,929.61 | $275,422.87 | $288,403.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,183.10 / $69,183.10 / $213,796.21
| Facility | | $69,183.10 | $69,183.10 | $213,796.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,176.38 / $114,815.36 / $177,827.94
| Facility | | $83,176.38 | $114,815.36 | $177,827.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $81,283.05 / $102,329.30 / $112,201.85
| Facility | | $81,283.05 | $102,329.30 | $112,201.85 |