- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,307.50 / $40,763.80 / $82,821.00
| Facility | | $21,307.50 | $40,763.80 | $82,821.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62,309.47 / $62,309.47 / $66,202.64
| Facility | | $62,309.47 | $62,309.47 | $66,202.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $24,080.73 / $37,445.64
| Facility | | $7,500.00 | $24,080.73 | $37,445.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,500.00 / $23,735.52 / $66,202.64
| Facility | | $7,500.00 | $23,735.52 | $66,202.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,540.00 / $1,540.00 / $1,540.00
| Facility | | $1,540.00 | $1,540.00 | $1,540.00 |