- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,261.40 / $19,678.40 / $24,235.60
| Facility | | $16,261.40 | $19,678.40 | $24,235.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,916.26 / $17,381.18 / $17,682.29
| Facility | | $15,916.26 | $17,381.18 | $17,682.29 |
- 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
- $15,528.89 / $20,075.91 / $31,458.69
| Facility | | $15,528.89 | $20,075.91 | $31,458.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,035.57 / $25,368.93 / $33,480.15
| Facility | | $19,035.57 | $25,368.93 | $33,480.15 |