- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,601.40 / $21,300.00 / $26,232.70
| Facility | | $17,601.40 | $21,300.00 | $26,232.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,227.88 / $18,813.53 / $19,139.43
| Facility | | $17,227.88 | $18,813.53 | $19,139.43 |
- 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
- $16,808.58 / $21,730.31 / $34,051.11
| Facility | | $16,808.58 | $21,730.31 | $34,051.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,604.24 / $27,459.51 / $36,239.15
| Facility | | $20,604.24 | $27,459.51 | $36,239.15 |