- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,031.59 / $24,240.80 / $29,854.60
| Facility | | $20,031.59 | $24,240.80 | $29,854.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,606.47 / $21,411.05 / $21,781.96
| Facility | | $19,606.47 | $21,411.05 | $21,781.96 |
- 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
- $19,129.28 / $24,730.54 / $38,752.43
| Facility | | $19,129.28 | $24,730.54 | $38,752.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,449.00 / $31,250.75 / $41,242.57
| Facility | | $23,449.00 | $31,250.75 | $41,242.57 |