- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,668.20 / $18,960.59 / $23,351.60
| Facility | | $15,668.20 | $18,960.59 | $23,351.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,335.73 / $16,747.22 / $17,037.34
| Facility | | $15,335.73 | $16,747.22 | $17,037.34 |
- 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
- $14,962.48 / $19,343.65 / $30,311.25
| Facility | | $14,962.48 | $19,343.65 | $30,311.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,341.25 / $24,443.61 / $32,258.98
| Facility | | $18,341.25 | $24,443.61 | $32,258.98 |