- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,560.00 / $5,560.00 / $5,560.00
| Facility | | $5,560.00 | $5,560.00 | $5,560.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,000.00 / $15,000.00 / $15,000.00
| Facility | | $15,000.00 | $15,000.00 | $15,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,210.00 / $5,578.38 / $7,410.00
| Facility | | $2,210.00 | $5,578.38 | $7,410.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,809.00 / $4,809.00 / $4,809.00
| Facility | | $4,809.00 | $4,809.00 | $4,809.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,145.75 / $45,366.94 / $46,217.08
| Facility | | $45,145.75 | $45,366.94 | $46,217.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,070.62 / $8,215.20 / $9,821.48
| Facility | | $8,070.62 | $8,215.20 | $9,821.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,187.00 / $5,578.38 / $8,416.00
| Facility | | $1,187.00 | $5,578.38 | $8,416.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,844.00 / $46,106.18 / $46,292.80
| Facility | | $8,844.00 | $46,106.18 | $46,292.80 |