- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,485.30 / $24,789.90 / $30,530.80
| Facility | | $20,485.30 | $24,789.90 | $30,530.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,050.58 / $21,896.03 / $22,275.34
| Facility | | $20,050.58 | $21,896.03 | $22,275.34 |
- 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
- $19,562.58 / $25,290.71 / $39,630.21
| Facility | | $19,562.58 | $25,290.71 | $39,630.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,980.14 / $31,958.61 / $42,176.75
| Facility | | $23,980.14 | $31,958.61 | $42,176.75 |