- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,044.80 / $20,626.50 / $25,403.20
| Facility | | $17,044.80 | $20,626.50 | $25,403.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,683.09 / $18,218.59 / $18,534.21
| Facility | | $16,683.09 | $18,218.59 | $18,534.21 |
- 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
- $16,277.06 / $21,043.15 / $32,974.33
| Facility | | $16,277.06 | $21,043.15 | $32,974.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.68 / $26,591.18 / $35,093.19
| Facility | | $19,952.68 | $26,591.18 | $35,093.19 |