- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,070.30 / $18,237.09 / $22,460.40
| Facility | | $15,070.30 | $18,237.09 | $22,460.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,750.49 / $16,108.12 / $16,387.16
| Facility | | $14,750.49 | $16,108.12 | $16,387.16 |
- 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
- $14,391.49 / $18,605.46 / $29,154.52
| Facility | | $14,391.49 | $18,605.46 | $29,154.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,641.33 / $23,510.80 / $31,027.92
| Facility | | $17,641.33 | $23,510.80 | $31,027.92 |