- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,995.90 / $33,878.80 / $41,724.50
| Facility | | $27,995.90 | $33,878.80 | $41,724.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,401.83 / $29,923.88 / $30,442.27
| Facility | | $27,401.83 | $29,923.88 | $30,442.27 |
- 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
- $26,734.91 / $34,563.18 / $54,160.04
| Facility | | $26,734.91 | $34,563.18 | $54,160.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,734.91 / $37,656.00 / $51,096.30
| Facility | | $26,734.91 | $37,656.00 | $51,096.30 |