- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,278.40 / $32,278.40 / $32,278.40
| Facility | | $32,278.40 | $32,278.40 | $32,278.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,810.84 / $25,685.47 / $25,685.47
| Facility | | $24,810.84 | $25,685.47 | $25,685.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,150.96 / $21,349.08 / $40,420.21
| Facility | | $15,150.96 | $21,349.08 | $40,420.21 |
- 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
- $15,150.96 / $21,349.08 / $39,204.26
| Facility | | $15,150.96 | $21,349.08 | $39,204.26 |