- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,561.70 / $22,462.20 / $27,664.00
| Facility | | $18,561.70 | $22,462.20 | $27,664.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,167.84 / $19,840.00 / $20,183.70
| Facility | | $18,167.84 | $19,840.00 | $20,183.70 |
- 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
- $17,725.66 / $22,915.92 / $35,908.94
| Facility | | $17,725.66 | $22,915.92 | $35,908.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,728.42 / $28,957.71 / $38,216.37
| Facility | | $21,728.42 | $28,957.71 | $38,216.37 |