- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,404.09 / $22,271.40 / $27,429.00
| Facility | | $18,404.09 | $22,271.40 | $27,429.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,013.53 / $19,671.49 / $20,012.27
| Facility | | $18,013.53 | $19,671.49 | $20,012.27 |
- 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
- $17,575.11 / $22,721.29 / $35,603.96
| Facility | | $17,575.11 | $22,721.29 | $35,603.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,543.87 / $28,711.76 / $37,891.78
| Facility | | $21,543.87 | $28,711.76 | $37,891.78 |