- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,433.40 / $19,886.59 / $24,492.00
| Facility | | $16,433.40 | $19,886.59 | $24,492.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,084.69 / $17,565.11 / $17,869.40
| Facility | | $16,084.69 | $17,565.11 | $17,869.40 |
- 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
- $15,693.21 / $20,288.34 / $31,791.57
| Facility | | $15,693.21 | $20,288.34 | $31,791.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,237.00 / $25,637.37 / $33,834.42
| Facility | | $19,237.00 | $25,637.37 | $33,834.42 |