- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,250.30 / $44,480.60 / $90,372.60
| Facility | | $23,250.30 | $44,480.60 | $90,372.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $67,990.78 / $67,990.78 / $72,238.95
| Facility | | $67,990.78 | $67,990.78 | $72,238.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $26,276.39 / $34,087.21
| Facility | | $7,500.00 | $26,276.39 | $34,087.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $21,606.73 / $72,238.95
| Facility | | $7,500.00 | $21,606.73 | $72,238.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,849.00 / $21,849.00 / $21,849.00
| Facility | | $21,849.00 | $21,849.00 | $21,849.00 |