- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,379.50 / $29,502.50 / $36,334.69
| Facility | | $24,379.50 | $29,502.50 | $36,334.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,862.16 / $26,058.43 / $26,509.85
| Facility | | $23,862.16 | $26,058.43 | $26,509.85 |
- 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
- $23,281.40 / $30,098.43 / $47,163.85
| Facility | | $23,281.40 | $30,098.43 | $47,163.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,538.73 / $38,033.89 / $50,194.49
| Facility | | $28,538.73 | $38,033.89 | $50,194.49 |