- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,549.70 / $41,227.10 / $83,762.30
| Facility | | $21,549.70 | $41,227.10 | $83,762.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,017.62 / $63,017.62 / $66,955.05
| Facility | | $63,017.62 | $63,017.62 | $66,955.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $24,354.41 / $38,763.01
| Facility | | $7,500.00 | $24,354.41 | $38,763.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $24,570.56 / $66,955.05
| Facility | | $7,500.00 | $24,570.56 | $66,955.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,251.00 / $20,251.00 / $20,251.00
| Facility | | $20,251.00 | $20,251.00 | $20,251.00 |