- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $28,301.60 / $34,248.69 / $42,180.10
| Facility | | $28,301.60 | $34,248.69 | $42,180.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,701.04 / $30,250.63 / $30,774.68
| Facility | | $27,701.04 | $30,250.63 | $30,774.68 |
- 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
- $27,026.84 / $34,940.58 / $54,751.43
| Facility | | $27,026.84 | $34,940.58 | $54,751.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,129.96 / $44,152.67 / $58,269.63
| Facility | | $33,129.96 | $44,152.67 | $58,269.63 |