- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,134.40 / $24,365.30 / $30,007.90
| Facility | | $20,134.40 | $24,365.30 | $30,007.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,707.15 / $21,520.99 / $21,893.81
| Facility | | $19,707.15 | $21,520.99 | $21,893.81 |
- 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
- $19,227.50 / $24,857.53 / $38,951.42
| Facility | | $19,227.50 | $24,857.53 | $38,951.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,569.41 / $31,411.22 / $41,454.33
| Facility | | $23,569.41 | $31,411.22 | $41,454.33 |