- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $50,118.72 / $50,118.72
| Facility | | $50,118.72 | $50,118.72 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $50,118.72 / $89,125.09 / $144,543.98
| Facility | | $50,118.72 | $89,125.09 | $144,543.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $77,624.71 / $123,026.88
| Facility | | $30,902.95 | $77,624.71 | $123,026.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $109,647.82 / $114,815.36
| Facility | | $56,234.13 | $109,647.82 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $70,794.58 / $70,794.58 / $125,892.54
| Facility | | $70,794.58 | $70,794.58 | $125,892.54 |