- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,601.10 / $27,350.30 / $33,684.19
| Facility | | $22,601.10 | $27,350.30 | $33,684.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,121.50 / $24,157.55 / $24,576.05
| Facility | | $22,121.50 | $24,157.55 | $24,576.05 |
- 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
- $21,583.10 / $27,902.85 / $43,723.41
| Facility | | $21,583.10 | $27,902.85 | $43,723.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,456.93 / $35,259.44 / $46,532.97
| Facility | | $26,456.93 | $35,259.44 | $46,532.97 |