- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,368.30 / $23,438.20 / $28,866.00
| Facility | | $19,368.30 | $23,438.20 | $28,866.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,957.25 / $20,702.07 / $21,060.70
| Facility | | $18,957.25 | $20,702.07 | $21,060.70 |
- 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
- $18,495.86 / $23,911.65 / $37,469.24
| Facility | | $18,495.86 | $23,911.65 | $37,469.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,672.54 / $30,215.96 / $39,876.92
| Facility | | $22,672.54 | $30,215.96 | $39,876.92 |