- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $92,455.30 / $92,455.30 / $92,455.30
| Facility | | $92,455.30 | $92,455.30 | $92,455.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $71,065.84 / $73,571.03 / $73,571.03
| Facility | | $71,065.84 | $73,571.03 | $73,571.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,396.98 / $61,150.29 / $101,602.15
| Facility | | $43,396.98 | $61,150.29 | $101,602.15 |
- 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
- $43,396.98 / $61,150.29 / $112,292.97
| Facility | | $43,396.98 | $61,150.29 | $112,292.97 |