- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $97,723.72 / $97,723.72
| Facility | | $75,857.76 | $97,723.72 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,176.38 / $109,647.82 / $165,958.69
| Facility | | $83,176.38 | $109,647.82 | $165,958.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,176.38 / $93,325.43 / $125,892.54
| Facility | | $83,176.38 | $93,325.43 | $125,892.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $87,096.36 / $93,325.43
| Facility | | $56,234.13 | $87,096.36 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,199.52 / $91,201.08 / $194,984.46
| Facility | | $30,199.52 | $91,201.08 | $194,984.46 |