- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,704.30 / $21,424.50 / $26,386.00
| Facility | | $17,704.30 | $21,424.50 | $26,386.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,328.56 / $18,923.47 / $19,251.29
| Facility | | $17,328.56 | $18,923.47 | $19,251.29 |
- 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
- $16,906.81 / $21,857.30 / $34,250.08
| Facility | | $16,906.81 | $21,857.30 | $34,250.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,724.65 / $27,619.97 / $36,450.93
| Facility | | $20,724.65 | $27,619.97 | $36,450.93 |