- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,219.80 / $29,533.00 / $38,916.69
| Facility | | $24,219.80 | $29,533.00 | $38,916.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,519.10 / $31,282.52 / $40,930.40
| Facility | | $21,519.10 | $31,282.52 | $40,930.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,000.00 / $34,765.60 / $46,180.42
| Facility | | $20,000.00 | $34,765.60 | $46,180.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,016.00 / $20,016.00 / $20,016.00
| Facility | | $20,016.00 | $20,016.00 | $20,016.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,000.00 / $34,451.86 / $50,466.00
| Facility | | $20,000.00 | $34,451.86 | $50,466.00 |