- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,756.60 / $33,589.10 / $41,367.80
| Facility | | $27,756.60 | $33,589.10 | $41,367.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,167.55 / $29,668.04 / $30,181.99
| Facility | | $27,167.55 | $29,668.04 | $30,181.99 |
- 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
- $26,506.33 / $34,267.66 / $53,696.98
| Facility | | $26,506.33 | $34,267.66 | $53,696.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,727.70 / $38,480.51 / $57,147.42
| Facility | | $27,727.70 | $38,480.51 | $57,147.42 |