- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,041.40 / $23,042.60 / $28,378.90
| Facility | | $19,041.40 | $23,042.60 | $28,378.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,637.34 / $20,352.72 / $20,705.30
| Facility | | $18,637.34 | $20,352.72 | $20,705.30 |
- 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
- $18,183.74 / $23,508.13 / $36,836.94
| Facility | | $18,183.74 | $23,508.13 | $36,836.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,289.94 / $29,706.06 / $39,203.99
| Facility | | $22,289.94 | $29,706.06 | $39,203.99 |