- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,155.00 / $31,651.10 / $38,980.90
| Facility | | $26,155.00 | $31,651.10 | $38,980.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,600.01 / $27,956.22 / $28,440.52
| Facility | | $25,600.01 | $27,956.22 | $28,440.52 |
- 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
- $24,976.94 / $32,290.45 / $50,598.72
| Facility | | $24,976.94 | $32,290.45 | $50,598.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,617.16 / $40,803.83 / $53,850.07
| Facility | | $30,617.16 | $40,803.83 | $53,850.07 |