- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $83,847.10 / $83,847.10 / $83,847.10
| Facility | | $83,847.10 | $83,847.10 | $83,847.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $64,449.18 / $66,721.13 / $66,721.13
| Facility | | $64,449.18 | $66,721.13 | $66,721.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,356.46 / $55,456.83 / $98,017.47
| Facility | | $39,356.46 | $55,456.83 | $98,017.47 |
- 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
- $39,356.46 / $55,456.83 / $101,837.82
| Facility | | $39,356.46 | $55,456.83 | $101,837.82 |