- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $41,058.10 / $41,058.10 / $41,058.10
| Facility | | $41,058.10 | $41,058.10 | $41,058.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,559.36 / $32,671.88 / $32,671.88
| Facility | | $31,559.36 | $32,671.88 | $32,671.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,272.00 / $27,156.00 / $49,804.57
| Facility | | $19,272.00 | $27,156.00 | $49,804.57 |
- 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
- $19,272.00 / $27,156.00 / $49,867.76
| Facility | | $19,272.00 | $27,156.00 | $49,867.76 |