- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,970.50 / $47,970.50 / $47,970.50
| Facility | | $47,970.50 | $47,970.50 | $47,970.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,872.57 / $38,172.39 / $38,172.39
| Facility | | $36,872.57 | $38,172.39 | $38,172.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,516.56 / $31,727.88 / $57,325.72
| Facility | | $22,516.56 | $31,727.88 | $57,325.72 |
- 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
- $22,516.56 / $31,727.88 / $58,263.30
| Facility | | $22,516.56 | $31,727.88 | $58,263.30 |