- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87,096.36 / $87,096.36 / $87,096.36
| Facility | | $87,096.36 | $87,096.36 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $107,151.93 / $213,796.21 / $354,813.39
| Facility | | $107,151.93 | $213,796.21 | $354,813.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263,026.80 / $346,736.85 / $363,078.05
| Facility | | $263,026.80 | $346,736.85 | $363,078.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $87,096.36 / $87,096.36 / $218,776.16
| Facility | | $87,096.36 | $87,096.36 | $218,776.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102,329.30 / $147,910.84 / $213,796.21
| Facility | | $102,329.30 | $147,910.84 | $213,796.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102,329.30 / $128,824.96 / $141,253.75
| Facility | | $102,329.30 | $128,824.96 | $141,253.75 |