- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,148.20 / $18,331.30 / $22,576.50
| Facility | | $15,148.20 | $18,331.30 | $22,576.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,826.70 / $16,191.35 / $16,471.84
| Facility | | $14,826.70 | $16,191.35 | $16,471.84 |
- 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
- $14,465.84 / $18,701.59 / $29,305.15
| Facility | | $14,465.84 | $18,701.59 | $29,305.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,732.48 / $23,632.27 / $31,188.23
| Facility | | $17,732.48 | $23,632.27 | $31,188.23 |