- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,346.20 / $18,570.90 / $22,871.60
| Facility | | $15,346.20 | $18,570.90 | $22,871.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,020.53 / $16,403.00 / $16,687.16
| Facility | | $15,020.53 | $16,403.00 | $16,687.16 |
- 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
- $14,654.95 / $18,946.08 / $29,688.25
| Facility | | $14,654.95 | $18,946.08 | $29,688.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,964.29 / $23,941.21 / $31,595.95
| Facility | | $17,964.29 | $23,941.21 | $31,595.95 |