- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,862.59 / $22,826.30 / $28,112.40
| Facility | | $18,862.59 | $22,826.30 | $28,112.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,462.34 / $20,161.61 / $20,510.88
| Facility | | $18,462.34 | $20,161.61 | $20,510.88 |
- 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
- $18,013.00 / $23,287.39 / $36,491.03
| Facility | | $18,013.00 | $23,287.39 | $36,491.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,080.64 / $29,427.11 / $38,835.86
| Facility | | $22,080.64 | $29,427.11 | $38,835.86 |