- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $38,904.51
| Facility | | $38,904.51 | $38,904.51 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,686.94 / $66,069.34 / $100,000.00
| Facility | | $41,686.94 | $66,069.34 | $100,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $117,489.76 / $154,881.66 / $162,181.01
| Facility | | $117,489.76 | $154,881.66 | $162,181.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,904.51 / $38,904.51 / $89,125.09
| Facility | | $38,904.51 | $38,904.51 | $89,125.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $63,095.73 / $91,201.08
| Facility | | $43,651.58 | $63,095.73 | $91,201.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $57,543.99 / $63,095.73
| Facility | | $45,708.82 | $57,543.99 | $63,095.73 |