- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,827.00 / $14,848.90 / $41,304.10
| Facility | | $1,827.00 | $14,848.90 | $41,304.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $43,422.69 / $43,422.69 / $46,135.80
| Facility | | $43,422.69 | $43,422.69 | $46,135.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,950.00 / $14,315.80 / $40,578.22
| Facility | | $3,950.00 | $14,315.80 | $40,578.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $16,781.56 / $24,480.48
| Facility | | $7,500.00 | $16,781.56 | $24,480.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $15,517.35 / $46,135.80
| Facility | | $7,500.00 | $15,517.35 | $46,135.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.00 / $3,800.00 / $3,800.00
| Facility | | $3,800.00 | $3,800.00 | $3,800.00 |