- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,241.20 / $19,654.00 / $24,205.50
| Facility | | $16,241.20 | $19,654.00 | $24,205.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,896.51 / $17,359.61 / $17,660.34
| Facility | | $15,896.51 | $17,359.61 | $17,660.34 |
- 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
- $15,509.61 / $20,050.99 / $31,419.63
| Facility | | $15,509.61 | $20,050.99 | $31,419.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,011.93 / $25,337.43 / $33,438.58
| Facility | | $19,011.93 | $25,337.43 | $33,438.58 |