- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,519.04 / $10,309.20 / $12,696.60
| Facility | | $8,519.04 | $10,309.20 | $12,696.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,338.26 / $9,105.70 / $9,263.45
| Facility | | $8,338.26 | $9,105.70 | $9,263.45 |
- 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
- $8,135.32 / $10,517.42 / $16,480.66
| Facility | | $8,135.32 | $10,517.42 | $16,480.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,972.41 / $13,290.34 / $17,539.66
| Facility | | $9,972.41 | $13,290.34 | $17,539.66 |