- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,902.95 / $43,651.58 / $70,794.58
| Facility | | $30,902.95 | $43,651.58 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $26,915.35 / $48,977.88
| Facility | | $11,481.54 | $26,915.35 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $42,657.95 / $85,113.80
| Facility | | $25,703.96 | $42,657.95 | $85,113.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $109,647.82 / $109,647.82 / $109,647.82
| Facility | | $109,647.82 | $109,647.82 | $109,647.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,982.44 / $38,904.51 / $70,794.58
| Facility | | $16,982.44 | $38,904.51 | $70,794.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,915.35 / $37,153.52 / $91,201.08
| Facility | | $26,915.35 | $37,153.52 | $91,201.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $38,018.94 / $79,432.82
| Facility | | $13,182.57 | $38,018.94 | $79,432.82 |