- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,816.00 / $20,349.59 / $25,062.20
| Facility | | $16,816.00 | $20,349.59 | $25,062.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,459.16 / $17,974.06 / $18,285.43
| Facility | | $16,459.16 | $17,974.06 | $18,285.43 |
- 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
- $16,058.57 / $20,760.68 / $32,531.73
| Facility | | $16,058.57 | $20,760.68 | $32,531.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,684.87 / $26,234.25 / $34,622.15
| Facility | | $19,684.87 | $26,234.25 | $34,622.15 |