- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,378.60 / $19,820.30 / $24,410.30
| Facility | | $16,378.60 | $19,820.30 | $24,410.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,031.05 / $17,506.55 / $17,809.82
| Facility | | $16,031.05 | $17,506.55 | $17,809.82 |
- 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
- $15,640.88 / $20,220.70 / $31,685.57
| Facility | | $15,640.88 | $20,220.70 | $31,685.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,172.86 / $25,551.89 / $33,721.61
| Facility | | $19,172.86 | $25,551.89 | $33,721.61 |