- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $87,096.36 / $114,815.36
| Facility | | $53,703.18 | $87,096.36 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $75,857.76 / $109,647.82 / $134,896.29
| Facility | | $75,857.76 | $109,647.82 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104,712.85 / $104,712.85 / $104,712.85
| Facility | | $104,712.85 | $104,712.85 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $77,624.71 / $107,151.93
| Facility | | $53,703.18 | $77,624.71 | $107,151.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $104,712.85 / $104,712.85 / $104,712.85
| Facility | | $104,712.85 | $104,712.85 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,668.36 / $70,794.58 / $109,647.82
| Facility | | $44,668.36 | $70,794.58 | $109,647.82 |