- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,608.40 / $20,098.30 / $24,752.80
| Facility | | $16,608.40 | $20,098.30 | $24,752.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,255.93 / $17,752.12 / $18,059.65
| Facility | | $16,255.93 | $17,752.12 | $18,059.65 |
- 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
- $15,860.29 / $20,504.34 / $32,130.04
| Facility | | $15,860.29 | $20,504.34 | $32,130.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,441.81 / $25,910.32 / $34,194.64
| Facility | | $19,441.81 | $25,910.32 | $34,194.64 |