- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,383.91 / $67,464.70 / $85,152.50
| Facility | | $2,383.91 | $67,464.70 | $85,152.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $61,069.46 / $61,069.46 / $62,127.41
| Facility | | $61,069.46 | $61,069.46 | $62,127.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $150.00 / $150.00
| Facility | | $150.00 | $150.00 | $150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,770.00 / $67,583.53 / $104,278.71
| Facility | | $2,770.00 | $67,583.53 | $104,278.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $71,880.69 / $104,278.71
| Facility | | $4,317.00 | $71,880.69 | $104,278.71 |