- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,302.68 / $70,794.58 / $131,825.67
| Facility | | $26,302.68 | $70,794.58 | $131,825.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74,131.02 / $109,647.82 / $151,356.12
| Facility | | $74,131.02 | $109,647.82 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $58,884.37 / $93,325.43 / $120,226.44
| Facility | | $58,884.37 | $93,325.43 | $120,226.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $46,773.51 / $83,176.38 / $208,929.61
| Facility | | $46,773.51 | $83,176.38 | $208,929.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $70,794.58 / $114,815.36
| Facility | | $10,000.00 | $70,794.58 | $114,815.36 |