- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,360.90 / $17,378.50 / $21,403.10
| Facility | | $14,360.90 | $17,378.50 | $21,403.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,056.11 / $15,349.82 / $15,615.74
| Facility | | $14,056.11 | $15,349.82 | $15,615.74 |
- 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
- $13,714.00 / $17,729.61 / $27,782.06
| Facility | | $13,714.00 | $17,729.61 | $27,782.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,810.86 / $22,404.02 / $29,567.27
| Facility | | $16,810.86 | $22,404.02 | $29,567.27 |