- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,612.10 / $34,624.50 / $42,642.90
| Facility | | $28,612.10 | $34,624.50 | $42,642.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,004.95 / $30,582.51 / $31,112.31
| Facility | | $28,004.95 | $30,582.51 | $31,112.31 |
- 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
- $27,323.35 / $35,323.92 / $55,352.11
| Facility | | $27,323.35 | $35,323.92 | $55,352.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,493.43 / $44,637.07 / $58,908.91
| Facility | | $33,493.43 | $44,637.07 | $58,908.91 |