- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,122.10 / $27,980.90 / $34,460.69
| Facility | | $23,122.10 | $27,980.90 | $34,460.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,631.47 / $24,714.46 / $25,142.60
| Facility | | $22,631.47 | $24,714.46 | $25,142.60 |
- 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
- $22,080.65 / $28,546.10 / $44,731.36
| Facility | | $22,080.65 | $28,546.10 | $44,731.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,066.84 / $36,072.28 / $47,605.70
| Facility | | $27,066.84 | $36,072.28 | $47,605.70 |