- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,668.30 / $41,953.30 / $51,668.90
| Facility | | $34,668.30 | $41,953.30 | $51,668.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,932.62 / $37,055.76 / $37,697.69
| Facility | | $33,932.62 | $37,055.76 | $37,697.69 |
- 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
- $33,106.75 / $42,800.76 / $67,068.22
| Facility | | $33,106.75 | $42,800.76 | $67,068.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,582.82 / $54,085.18 / $71,377.87
| Facility | | $40,582.82 | $54,085.18 | $71,377.87 |