- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,066.20 / $24,282.70 / $29,906.20
| Facility | | $20,066.20 | $24,282.70 | $29,906.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,640.34 / $21,448.04 / $21,819.59
| Facility | | $19,640.34 | $21,448.04 | $21,819.59 |
- 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
- $19,162.33 / $24,773.26 / $38,819.37
| Facility | | $19,162.33 | $24,773.26 | $38,819.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,489.51 / $31,304.74 / $41,313.82
| Facility | | $23,489.51 | $31,304.74 | $41,313.82 |