- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,390.80 / $35,566.69 / $43,803.40
| Facility | | $29,390.80 | $35,566.69 | $43,803.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,767.08 / $31,414.79 / $31,959.00
| Facility | | $28,767.08 | $31,414.79 | $31,959.00 |
- 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
- $28,066.93 / $36,285.22 / $56,858.47
| Facility | | $28,066.93 | $36,285.22 | $56,858.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,404.92 / $45,851.83 / $60,512.06
| Facility | | $34,404.92 | $45,851.83 | $60,512.06 |