- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54,756.30 / $54,756.30 / $54,756.30
| Facility | | $54,756.30 | $54,756.30 | $54,756.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $42,088.51 / $43,572.20 / $43,572.20
| Facility | | $42,088.51 | $43,572.20 | $43,572.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,701.72 / $36,216.06 / $70,644.67
| Facility | | $25,701.72 | $36,216.06 | $70,644.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.00 / $950.00 / $950.00
| Facility | | $950.00 | $950.00 | $950.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,701.72 / $36,216.06 / $66,505.14
| Facility | | $25,701.72 | $36,216.06 | $66,505.14 |