- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,207.70 / $23,243.90 / $28,626.80
| Facility | | $19,207.70 | $23,243.90 | $28,626.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,800.12 / $20,530.48 / $20,886.14
| Facility | | $18,800.12 | $20,530.48 | $20,886.14 |
- 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
- $18,342.56 / $23,713.45 / $37,158.67
| Facility | | $18,342.56 | $23,713.45 | $37,158.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,484.62 / $29,965.51 / $39,546.40
| Facility | | $22,484.62 | $29,965.51 | $39,546.40 |