- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $46,773.51
| Facility | | $46,773.51 | $46,773.51 | $46,773.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,659.50 / $104,712.85 / $162,181.01
| Facility | | $61,659.50 | $104,712.85 | $162,181.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $141,253.75 / $186,208.71 / $194,984.46
| Facility | | $141,253.75 | $186,208.71 | $194,984.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $46,773.51 / $154,881.66
| Facility | | $46,773.51 | $46,773.51 | $154,881.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,255.96 / $85,113.80 / $128,824.96
| Facility | | $60,255.96 | $85,113.80 | $128,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $69,183.10 / $74,131.02
| Facility | | $53,703.18 | $69,183.10 | $74,131.02 |