- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,860.20 / $25,243.60 / $31,089.60
| Facility | | $20,860.20 | $25,243.60 | $31,089.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.53 / $22,296.75 / $22,683.01
| Facility | | $20,417.53 | $22,296.75 | $22,683.01 |
- 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
- $19,920.59 / $25,753.56 / $40,355.49
| Facility | | $19,920.59 | $25,753.56 | $40,355.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,419.01 / $32,543.49 / $42,948.64
| Facility | | $24,419.01 | $32,543.49 | $42,948.64 |