- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,438.40 / $23,523.10 / $28,970.60
| Facility | | $19,438.40 | $23,523.10 | $28,970.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,025.93 / $20,777.08 / $21,137.01
| Facility | | $19,025.93 | $20,777.08 | $21,137.01 |
- 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
- $18,562.88 / $23,998.28 / $37,604.99
| Facility | | $18,562.88 | $23,998.28 | $37,604.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,562.88 / $26,146.00 / $35,477.74
| Facility | | $18,562.88 | $26,146.00 | $35,477.74 |