- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,702.70 / $33,524.00 / $41,287.50
| Facility | | $27,702.70 | $33,524.00 | $41,287.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,114.86 / $29,610.50 / $30,123.46
| Facility | | $27,114.86 | $29,610.50 | $30,123.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $150.00 / $150.00 / $150.00
| Facility | | $150.00 | $150.00 | $150.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,454.92 / $34,201.19 / $53,592.83
| Facility | | $26,454.92 | $34,201.19 | $53,592.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,428.90 / $43,218.35 / $57,036.59
| Facility | | $32,428.90 | $43,218.35 | $57,036.59 |