- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,569.00 / $34,569.00 / $34,569.00
| Facility | | $34,569.00 | $34,569.00 | $34,569.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,571.47 / $27,508.16 / $27,508.16
| Facility | | $26,571.47 | $27,508.16 | $27,508.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,226.10 / $22,864.05 / $41,812.07
| Facility | | $16,226.10 | $22,864.05 | $41,812.07 |
- 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
- $16,226.10 / $22,864.05 / $41,986.26
| Facility | | $16,226.10 | $22,864.05 | $41,986.26 |