- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,909.70 / $32,564.30 / $40,105.60
| Facility | | $26,909.70 | $32,564.30 | $40,105.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,338.61 / $28,762.81 / $29,261.08
| Facility | | $26,338.61 | $28,762.81 | $29,261.08 |
- 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
- $25,697.57 / $33,222.08 / $52,058.58
| Facility | | $25,697.57 | $33,222.08 | $52,058.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $31,500.52 / $41,981.10 / $55,403.75
| Facility | | $31,500.52 | $41,981.10 | $55,403.75 |