- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $44,677.40 / $44,677.40 / $44,677.40
| Facility | | $44,677.40 | $44,677.40 | $44,677.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,341.33 / $35,551.93 / $35,551.93
| Facility | | $34,341.33 | $35,551.93 | $35,551.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,970.84 / $29,549.82 / $57,641.21
| Facility | | $20,970.84 | $29,549.82 | $57,641.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,450.00 / $1,450.00 / $1,450.00
| Facility | | $1,450.00 | $1,450.00 | $1,450.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,970.84 / $29,549.82 / $54,263.64
| Facility | | $20,970.84 | $29,549.82 | $54,263.64 |