- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,327.10 / $34,327.10 / $34,327.10
| Facility | | $34,327.10 | $34,327.10 | $34,327.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,385.57 / $27,315.71 / $27,315.71
| Facility | | $26,385.57 | $27,315.71 | $27,315.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,112.58 / $22,704.09 / $40,430.46
| Facility | | $16,112.58 | $22,704.09 | $40,430.46 |
- 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
- $16,112.58 / $22,704.09 / $41,692.51
| Facility | | $16,112.58 | $22,704.09 | $41,692.51 |