- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,749.06 / $46,073.70 / $58,153.30
| Facility | | $1,749.06 | $46,073.70 | $58,153.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,706.23 / $41,706.23 / $42,428.73
| Facility | | $41,706.23 | $41,706.23 | $42,428.73 |
- 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
- $2,640.00 / $46,154.89 / $71,215.16
| Facility | | $2,640.00 | $46,154.89 | $71,215.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,019.70 / $48,111.33 / $75,485.22
| Facility | | $3,019.70 | $48,111.33 | $75,485.22 |