- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,544.30 / $36,962.69 / $45,522.60
| Facility | | $30,544.30 | $36,962.69 | $45,522.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,896.16 / $32,647.79 / $33,213.36
| Facility | | $29,896.16 | $32,647.79 | $33,213.36 |
- 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
- $29,168.53 / $37,709.37 / $59,090.11
| Facility | | $29,168.53 | $37,709.37 | $59,090.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,755.28 / $47,651.47 / $62,887.10
| Facility | | $35,755.28 | $47,651.47 | $62,887.10 |