- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,144.20 / $49,200.20 / $86,578.20
| Facility | | $29,144.20 | $49,200.20 | $86,578.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,518.27 / $44,518.27 / $48,650.79
| Facility | | $44,518.27 | $44,518.27 | $48,650.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,499.00 / $41,257.94 / $66,659.30
| Facility | | $27,499.00 | $41,257.94 | $66,659.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,511.21 / $44,598.72 / $61,193.41
| Facility | | $26,511.21 | $44,598.72 | $61,193.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $102,422.50 / $102,422.50 / $120,201.50
| Facility | | $102,422.50 | $102,422.50 | $120,201.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,787.00 / $42,877.58 / $61,245.72
| Facility | | $1,787.00 | $42,877.58 | $61,245.72 |