- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,830.80 / $32,468.90 / $39,988.10
| Facility | | $26,830.80 | $32,468.90 | $39,988.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,261.46 / $28,678.55 / $29,175.37
| Facility | | $26,261.46 | $28,678.55 | $29,175.37 |
- 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
- $25,622.30 / $33,124.76 / $51,906.09
| Facility | | $25,622.30 | $33,124.76 | $51,906.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,408.25 / $41,858.12 / $55,241.45
| Facility | | $31,408.25 | $41,858.12 | $55,241.45 |