- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,425.70 / $29,558.30 / $36,403.50
| Facility | | $24,425.70 | $29,558.30 | $36,403.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,907.33 / $26,107.75 / $26,560.03
| Facility | | $23,907.33 | $26,107.75 | $26,560.03 |
- 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
- $23,325.46 / $30,155.40 / $47,253.12
| Facility | | $23,325.46 | $30,155.40 | $47,253.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,592.75 / $38,105.87 / $50,289.49
| Facility | | $28,592.75 | $38,105.87 | $50,289.49 |