- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $47,907.20 / $47,907.20 / $47,907.20
| Facility | | $47,907.20 | $47,907.20 | $47,907.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,823.94 / $38,122.04 / $38,122.04
| Facility | | $36,823.94 | $38,122.04 | $38,122.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,486.86 / $31,686.03 / $60,276.80
| Facility | | $22,486.86 | $31,686.03 | $60,276.80 |
- 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
- $22,486.86 / $31,686.03 / $58,186.45
| Facility | | $22,486.86 | $31,686.03 | $58,186.45 |