- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $66,069.34 / $123,026.88
| Facility | | $25,118.86 | $66,069.34 | $123,026.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $69,183.10 / $104,712.85 / $128,824.96
| Facility | | $69,183.10 | $104,712.85 | $128,824.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56,234.13 / $89,125.09 / $114,815.36
| Facility | | $56,234.13 | $89,125.09 | $114,815.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,651.58 / $77,624.71 / $194,984.46
| Facility | | $43,651.58 | $77,624.71 | $194,984.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $66,069.34 / $109,647.82
| Facility | | $10,000.00 | $66,069.34 | $109,647.82 |