- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54,954.09 / $54,954.09 / $54,954.09
| Facility | | $54,954.09 | $54,954.09 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $46,773.51 / $75,857.76
| Facility | | $25,703.96 | $46,773.51 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,810.72 / $64,565.42 / $109,647.82
| Facility | | $39,810.72 | $64,565.42 | $109,647.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,183.83 / $54,954.09 / $57,543.99
| Facility | | $28,183.83 | $54,954.09 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,307.81 / $36,307.81 / $66,069.34
| Facility | | $36,307.81 | $36,307.81 | $66,069.34 |