- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,224.50 / $25,684.50 / $31,632.60
| Facility | | $21,224.50 | $25,684.50 | $31,632.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,774.13 / $22,686.17 / $23,079.18
| Facility | | $20,774.13 | $22,686.17 | $23,079.18 |
- 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
- $20,268.52 / $26,203.36 / $41,060.32
| Facility | | $20,268.52 | $26,203.36 | $41,060.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,845.50 / $33,111.87 / $43,698.76
| Facility | | $24,845.50 | $33,111.87 | $43,698.76 |