- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,250.50 / $25,715.90 / $31,671.30
| Facility | | $21,250.50 | $25,715.90 | $31,671.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,799.54 / $22,713.92 / $23,107.40
| Facility | | $20,799.54 | $22,713.92 | $23,107.40 |
- 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
- $20,293.31 / $26,235.40 / $41,110.53
| Facility | | $20,293.31 | $26,235.40 | $41,110.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,875.88 / $33,152.37 / $43,752.20
| Facility | | $24,875.88 | $33,152.37 | $43,752.20 |