- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,933.00 / $26,541.90 / $32,688.50
| Facility | | $21,933.00 | $26,541.90 | $32,688.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,467.57 / $23,443.44 / $23,849.56
| Facility | | $21,467.57 | $23,443.44 | $23,849.56 |
- 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
- $20,945.09 / $27,078.03 / $42,430.92
| Facility | | $20,945.09 | $27,078.03 | $42,430.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,390.00 / $5,392.50 / $15,657.82
| Facility | | $3,390.00 | $5,392.50 | $15,657.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,674.84 / $34,217.16 / $45,157.43
| Facility | | $25,674.84 | $34,217.16 | $45,157.43 |