- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,262.60 / $18,469.70 / $22,747.00
| Facility | | $15,262.60 | $18,469.70 | $22,747.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,938.67 / $16,313.62 / $16,596.23
| Facility | | $14,938.67 | $16,313.62 | $16,596.23 |
- 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
- $14,575.09 / $18,842.82 / $29,526.46
| Facility | | $14,575.09 | $18,842.82 | $29,526.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,866.39 / $23,810.74 / $31,423.76
| Facility | | $17,866.39 | $23,810.74 | $31,423.76 |