- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,484.30 / $24,788.80 / $30,529.40
| Facility | | $20,484.30 | $24,788.80 | $30,529.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,049.64 / $21,895.00 / $22,274.30
| Facility | | $20,049.64 | $21,895.00 | $22,274.30 |
- 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
- $19,561.66 / $25,289.52 / $39,628.35
| Facility | | $19,561.66 | $25,289.52 | $39,628.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,979.02 / $31,957.11 / $42,174.77
| Facility | | $23,979.02 | $31,957.11 | $42,174.77 |