- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,559.30 / $24,879.50 / $30,641.20
| Facility | | $20,559.30 | $24,879.50 | $30,641.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,123.03 / $21,975.14 / $22,355.83
| Facility | | $20,123.03 | $21,975.14 | $22,355.83 |
- 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
- $19,633.27 / $25,382.09 / $39,773.40
| Facility | | $19,633.27 | $25,382.09 | $39,773.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,066.79 / $32,074.08 / $42,329.15
| Facility | | $24,066.79 | $32,074.08 | $42,329.15 |