- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,083.20 / $31,083.20 / $31,083.20
| Facility | | $31,083.20 | $31,083.20 | $31,083.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,892.16 / $24,734.40 / $24,734.40
| Facility | | $23,892.16 | $24,734.40 | $24,734.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,589.96 / $20,558.58 / $36,645.97
| Facility | | $14,589.96 | $20,558.58 | $36,645.97 |
- 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
- $14,589.96 / $20,558.58 / $37,752.62
| Facility | | $14,589.96 | $20,558.58 | $37,752.62 |