- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,274.59 / $20,904.50 / $25,745.60
| Facility | | $17,274.59 | $20,904.50 | $25,745.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,907.97 / $18,464.18 / $18,784.04
| Facility | | $16,907.97 | $18,464.18 | $18,784.04 |
- 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
- $16,496.46 / $21,326.80 / $33,418.81
| Facility | | $16,496.46 | $21,326.80 | $33,418.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,221.64 / $26,949.61 / $35,566.22
| Facility | | $20,221.64 | $26,949.61 | $35,566.22 |