- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,626.40 / $51,626.40 / $51,626.40
| Facility | | $51,626.40 | $51,626.40 | $51,626.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,682.65 / $41,081.53 / $41,081.53
| Facility | | $39,682.65 | $41,081.53 | $41,081.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,232.56 / $34,145.87 / $60,647.39
| Facility | | $24,232.56 | $34,145.87 | $60,647.39 |
- 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
- $24,232.56 / $34,145.87 / $62,703.58
| Facility | | $24,232.56 | $34,145.87 | $62,703.58 |