- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,920.30 / $22,896.10 / $28,198.40
| Facility | | $18,920.30 | $22,896.10 | $28,198.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,518.79 / $20,223.25 / $20,573.59
| Facility | | $18,518.79 | $20,223.25 | $20,573.59 |
- 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
- $18,068.08 / $23,358.60 / $36,602.62
| Facility | | $18,068.08 | $23,358.60 | $36,602.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,148.15 / $29,517.10 / $38,954.61
| Facility | | $22,148.15 | $29,517.10 | $38,954.61 |