- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,420.20 / $18,660.50 / $22,981.90
| Facility | | $15,420.20 | $18,660.50 | $22,981.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,092.98 / $16,482.13 / $16,767.66
| Facility | | $15,092.98 | $16,482.13 | $16,767.66 |
- 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
- $14,725.64 / $19,037.46 / $29,831.45
| Facility | | $14,725.64 | $19,037.46 | $29,831.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,050.93 / $24,056.69 / $31,748.35
| Facility | | $18,050.93 | $24,056.69 | $31,748.35 |