- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,976.80 / $24,174.50 / $29,772.90
| Facility | | $19,976.80 | $24,174.50 | $29,772.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,552.84 / $21,352.48 / $21,722.38
| Facility | | $19,552.84 | $21,352.48 | $21,722.38 |
- 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
- $19,076.96 / $24,662.89 / $38,646.43
| Facility | | $19,076.96 | $24,662.89 | $38,646.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,384.86 / $31,165.27 / $41,129.76
| Facility | | $23,384.86 | $31,165.27 | $41,129.76 |