- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,828.50 / $30,045.70 / $37,003.80
| Facility | | $24,828.50 | $30,045.70 | $37,003.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,301.57 / $26,538.27 / $26,998.01
| Facility | | $24,301.57 | $26,538.27 | $26,998.01 |
- 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
- $23,710.10 / $30,652.67 / $48,032.33
| Facility | | $23,710.10 | $30,652.67 | $48,032.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,064.25 / $38,734.25 / $51,118.78
| Facility | | $29,064.25 | $38,734.25 | $51,118.78 |