- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $51,647.50 / $51,647.50 / $51,647.50
| Facility | | $51,647.50 | $51,647.50 | $51,647.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $39,698.86 / $41,098.32 / $41,098.32
| Facility | | $39,698.86 | $41,098.32 | $41,098.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,242.46 / $34,159.83 / $65,939.87
| Facility | | $24,242.46 | $34,159.83 | $65,939.87 |
- 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
- $24,242.46 / $34,159.83 / $62,729.20
| Facility | | $24,242.46 | $34,159.83 | $62,729.20 |