- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,121.90 / $24,350.20 / $29,989.30
| Facility | | $20,121.90 | $24,350.20 | $29,989.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,694.91 / $21,507.63 / $21,880.22
| Facility | | $19,694.91 | $21,507.63 | $21,880.22 |
- 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
- $19,215.58 / $24,842.10 / $38,927.24
| Facility | | $19,215.58 | $24,842.10 | $38,927.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,554.78 / $31,391.72 / $41,428.61
| Facility | | $23,554.78 | $31,391.72 | $41,428.61 |