- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,450.80 / $29,450.80 / $29,450.80
| Facility | | $29,450.80 | $29,450.80 | $29,450.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,637.36 / $23,435.36 / $23,435.36
| Facility | | $22,637.36 | $23,435.36 | $23,435.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,823.70 / $19,478.84 / $35,435.14
| Facility | | $13,823.70 | $19,478.84 | $35,435.14 |
- 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
- $13,823.70 / $19,478.84 / $35,769.87
| Facility | | $13,823.70 | $19,478.84 | $35,769.87 |