- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,337.00 / $25,820.60 / $31,800.20
| Facility | | $21,337.00 | $25,820.60 | $31,800.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,884.22 / $22,806.39 / $23,201.48
| Facility | | $20,884.22 | $22,806.39 | $23,201.48 |
- 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
- $20,375.93 / $26,342.21 / $41,277.90
| Facility | | $20,375.93 | $26,342.21 | $41,277.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,977.16 / $33,287.33 / $43,930.32
| Facility | | $24,977.16 | $33,287.33 | $43,930.32 |