- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,247.34 / $37,500.00 / $70,750.00
| Facility | | $1,247.34 | $37,500.00 | $70,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,615.69 / $82,228.23 / $163,419.71
| Facility | | $30,615.69 | $82,228.23 | $163,419.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,713.20 / $31,713.20 / $40,752.03
| Facility | | $31,713.20 | $31,713.20 | $40,752.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.72 / $1,410.00 / $2,153.00
| Facility | | $922.72 | $1,410.00 | $2,153.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,117.00 / $31,007.00 / $77,327.00
| Facility | | $2,117.00 | $31,007.00 | $77,327.00 |