- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,276.10 / $36,638.10 / $45,122.90
| Facility | | $30,276.10 | $36,638.10 | $45,122.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,633.65 / $32,361.11 / $32,921.72
| Facility | | $29,633.65 | $32,361.11 | $32,921.72 |
- 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
- $28,912.41 / $37,378.26 / $58,571.25
| Facility | | $28,912.41 | $37,378.26 | $58,571.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,441.32 / $47,233.05 / $62,334.90
| Facility | | $35,441.32 | $47,233.05 | $62,334.90 |