- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,381.30 / $21,033.60 / $25,904.60
| Facility | | $17,381.30 | $21,033.60 | $25,904.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,012.41 / $18,578.23 / $18,900.07
| Facility | | $17,012.41 | $18,578.23 | $18,900.07 |
- 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
- $16,598.36 / $21,458.53 / $33,625.24
| Facility | | $16,598.36 | $21,458.53 | $33,625.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,346.55 / $27,116.08 / $35,785.92
| Facility | | $20,346.55 | $27,116.08 | $35,785.92 |