- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,640.30 / $28,607.90 / $35,233.00
| Facility | | $23,640.30 | $28,607.90 | $35,233.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,138.61 / $25,268.28 / $25,706.02
| Facility | | $23,138.61 | $25,268.28 | $25,706.02 |
- 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
- $22,575.46 / $29,185.79 / $45,733.74
| Facility | | $22,575.46 | $29,185.79 | $45,733.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,673.38 / $36,880.62 / $48,672.49
| Facility | | $27,673.38 | $36,880.62 | $48,672.49 |