- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,778.80 / $19,094.40 / $23,516.30
| Facility | | $15,778.80 | $19,094.40 | $23,516.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,443.93 / $16,865.39 / $17,157.55
| Facility | | $15,443.93 | $16,865.39 | $17,157.55 |
- 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
- $15,068.05 / $19,480.14 / $30,525.12
| Facility | | $15,068.05 | $19,480.14 | $30,525.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,470.66 / $24,616.08 / $32,486.59
| Facility | | $18,470.66 | $24,616.08 | $32,486.59 |