- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,032.30 / $25,451.80 / $31,346.00
| Facility | | $21,032.30 | $25,451.80 | $31,346.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,585.95 / $22,480.67 / $22,870.12
| Facility | | $20,585.95 | $22,480.67 | $22,870.12 |
- 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
- $20,084.91 / $25,966.00 / $40,688.37
| Facility | | $20,084.91 | $25,966.00 | $40,688.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,620.44 / $32,811.94 / $43,302.92
| Facility | | $24,620.44 | $32,811.94 | $43,302.92 |