- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $42,657.95 / $72,443.60
| Facility | | $20,892.96 | $42,657.95 | $72,443.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $38,904.51 / $104,712.85
| Facility | | $6,165.95 | $38,904.51 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $43,651.58 / $61,659.50
| Facility | | $23,988.33 | $43,651.58 | $61,659.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $60,255.96 / $60,255.96 / $60,255.96
| Facility | | $60,255.96 | $60,255.96 | $60,255.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $38,904.51 / $104,712.85
| Facility | | $6,165.95 | $38,904.51 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $38,904.51 / $104,712.85
| Facility | | $6,165.95 | $38,904.51 | $104,712.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $31,622.78 / $91,201.08
| Facility | | $6,165.95 | $31,622.78 | $91,201.08 |