- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,692.40 / $37,141.80 / $45,743.20
| Facility | | $30,692.40 | $37,141.80 | $45,743.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,041.06 / $32,806.01 / $33,374.33
| Facility | | $30,041.06 | $32,806.01 | $33,374.33 |
- 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
- $29,309.90 / $37,892.15 / $59,376.50
| Facility | | $29,309.90 | $37,892.15 | $59,376.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,928.58 / $47,882.42 / $63,191.90
| Facility | | $35,928.58 | $47,882.42 | $63,191.90 |