- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,004.10 / $36,308.90 / $44,717.40
| Facility | | $30,004.10 | $36,308.90 | $44,717.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,367.37 / $32,070.33 / $32,625.90
| Facility | | $29,367.37 | $32,070.33 | $32,625.90 |
- 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
- $28,652.62 / $37,042.40 / $58,044.96
| Facility | | $28,652.62 | $37,042.40 | $58,044.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,122.86 / $46,808.64 / $61,774.79
| Facility | | $35,122.86 | $46,808.64 | $61,774.79 |