- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,622.78 / $45,708.82 / $58,884.37
| Facility | | $31,622.78 | $45,708.82 | $58,884.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $19,498.45 / $41,686.94
| Facility | | $10,000.00 | $19,498.45 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $41,686.94
| Facility | | $16,218.10 | $22,387.21 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,218.10 / $22,387.21 / $41,686.94
| Facility | | $16,218.10 | $22,387.21 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $28,840.32 / $45,708.82
| Facility | | $5,370.32 | $28,840.32 | $45,708.82 |