- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,958.30 / $20,521.80 / $25,274.30
| Facility | | $16,958.30 | $20,521.80 | $25,274.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,598.41 / $18,126.13 / $18,440.14
| Facility | | $16,598.41 | $18,126.13 | $18,440.14 |
- 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
- $16,194.44 / $20,936.34 / $32,806.97
| Facility | | $16,194.44 | $20,936.34 | $32,806.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,851.41 / $26,456.21 / $34,915.07
| Facility | | $19,851.41 | $26,456.21 | $34,915.07 |