- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,941.60 / $36,233.30 / $44,624.30
| Facility | | $29,941.60 | $36,233.30 | $44,624.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,306.21 / $32,003.54 / $32,557.96
| Facility | | $29,306.21 | $32,003.54 | $32,557.96 |
- 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
- $28,592.95 / $36,965.26 / $57,924.08
| Facility | | $28,592.95 | $36,965.26 | $57,924.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,049.72 / $46,711.16 / $61,646.14
| Facility | | $35,049.72 | $46,711.16 | $61,646.14 |