- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,951.50 / $30,194.60 / $37,187.19
| Facility | | $24,951.50 | $30,194.60 | $37,187.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,422.00 / $26,669.79 / $27,131.81
| Facility | | $24,422.00 | $26,669.79 | $27,131.81 |
- 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
- $23,827.61 / $30,804.58 / $48,270.37
| Facility | | $23,827.61 | $30,804.58 | $48,270.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,208.29 / $38,926.21 / $51,372.12
| Facility | | $29,208.29 | $38,926.21 | $51,372.12 |