- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $50,118.72 / $93,325.43
| Facility | | $20,417.38 | $50,118.72 | $93,325.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $52,480.75 / $79,432.82 / $97,723.72
| Facility | | $52,480.75 | $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 / $147,910.84
| Facility | | $33,113.11 | $58,884.37 | $147,910.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $22,387.21
| Facility | | $22,387.21 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $52,480.75 / $83,176.38
| Facility | | $10,000.00 | $52,480.75 | $83,176.38 |