- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,491.69 / $75,552.30 / $153,502.00
| Facility | | $39,491.69 | $75,552.30 | $153,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $115,485.37 / $115,485.37 / $122,701.05
| Facility | | $115,485.37 | $115,485.37 | $122,701.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $44,631.61 / $71,500.97
| Facility | | $7,500.00 | $44,631.61 | $71,500.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $45,322.03 / $122,701.05
| Facility | | $7,500.00 | $45,322.03 | $122,701.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $37,112.00 / $37,112.00 / $37,112.00
| Facility | | $37,112.00 | $37,112.00 | $37,112.00 |