- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,067.60 / $26,704.70 / $32,889.10
| Facility | | $22,067.60 | $26,704.70 | $32,889.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,599.30 / $23,587.29 / $23,995.91
| Facility | | $21,599.30 | $23,587.29 | $23,995.91 |
- 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
- $21,073.61 / $27,244.18 / $42,691.27
| Facility | | $21,073.61 | $27,244.18 | $42,691.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,832.39 / $34,427.11 / $45,434.52
| Facility | | $25,832.39 | $34,427.11 | $45,434.52 |