- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,357.50 / $24,635.20 / $30,340.30
| Facility | | $20,357.50 | $24,635.20 | $30,340.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,925.43 / $21,759.37 / $22,136.32
| Facility | | $19,925.43 | $21,759.37 | $22,136.32 |
- 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
- $19,440.49 / $25,132.86 / $39,382.87
| Facility | | $19,440.49 | $25,132.86 | $39,382.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,830.48 / $31,759.15 / $41,913.51
| Facility | | $23,830.48 | $31,759.15 | $41,913.51 |