- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,646.30 / $32,245.50 / $39,713.00
| Facility | | $26,646.30 | $32,245.50 | $39,713.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,080.81 / $28,481.27 / $28,974.67
| Facility | | $26,080.81 | $28,481.27 | $28,974.67 |
- 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
- $25,446.04 / $32,896.91 / $51,549.02
| Facility | | $25,446.04 | $32,896.91 | $51,549.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,192.19 / $41,570.18 / $54,861.44
| Facility | | $31,192.19 | $41,570.18 | $54,861.44 |