- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $50,118.72 / $93,325.43
| Facility | | $19,054.61 | $50,118.72 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $53,703.18 / $79,432.82 / $97,723.72
| Facility | | $53,703.18 | $79,432.82 | $97,723.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,657.95 / $67,608.30 / $87,096.36
| Facility | | $42,657.95 | $67,608.30 | $87,096.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $58,884.37 / $151,356.12
| Facility | | $33,113.11 | $58,884.37 | $151,356.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,877.62 / $21,877.62 / $21,877.62
| Facility | | $21,877.62 | $21,877.62 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $51,286.14 / $83,176.38
| Facility | | $10,000.00 | $51,286.14 | $83,176.38 |