- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,050.80 / $24,264.10 / $29,883.30
| Facility | | $20,050.80 | $24,264.10 | $29,883.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,625.29 / $21,431.60 / $21,802.87
| Facility | | $19,625.29 | $21,431.60 | $21,802.87 |
- 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
- $19,147.64 / $24,754.27 / $38,789.62
| Facility | | $19,147.64 | $24,754.27 | $38,789.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,471.51 / $31,280.74 / $41,282.15
| Facility | | $23,471.51 | $31,280.74 | $41,282.15 |