- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,269.20 / $37,839.80 / $46,602.90
| Facility | | $31,269.20 | $37,839.80 | $46,602.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,605.60 / $33,422.51 / $34,001.51
| Facility | | $30,605.60 | $33,422.51 | $34,001.51 |
- 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
- $29,860.70 / $38,604.23 / $60,492.32
| Facility | | $29,860.70 | $38,604.23 | $60,492.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $36,603.76 / $48,782.24 / $64,379.42
| Facility | | $36,603.76 | $48,782.24 | $64,379.42 |