- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $63,095.73
| Facility | | $63,095.73 | $63,095.73 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,863.01 / $79,432.82 / $123,026.88
| Facility | | $47,863.01 | $79,432.82 | $123,026.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190,546.07 / $251,188.64 / $263,026.80
| Facility | | $190,546.07 | $251,188.64 | $263,026.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $63,095.73 / $63,095.73 / $134,896.29
| Facility | | $63,095.73 | $63,095.73 | $134,896.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $74,131.02 / $93,325.43 / $100,000.00
| Facility | | $74,131.02 | $93,325.43 | $100,000.00 |