- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,520.40 / $22,412.10 / $27,602.40
| Facility | | $18,520.40 | $22,412.10 | $27,602.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,127.38 / $19,795.82 / $20,138.75
| Facility | | $18,127.38 | $19,795.82 | $20,138.75 |
- 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
- $17,686.18 / $22,864.89 / $35,828.98
| Facility | | $17,686.18 | $22,864.89 | $35,828.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,680.03 / $28,893.22 / $38,131.26
| Facility | | $21,680.03 | $28,893.22 | $38,131.26 |