- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,226.10 / $13,585.00 / $16,731.09
| Facility | | $11,226.10 | $13,585.00 | $16,731.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,987.83 / $11,999.15 / $12,207.01
| Facility | | $10,987.83 | $11,999.15 | $12,207.01 |
- 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
- $10,720.40 / $13,859.45 / $21,717.58
| Facility | | $10,720.40 | $13,859.45 | $21,717.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,141.25 / $17,513.50 / $23,113.10
| Facility | | $13,141.25 | $17,513.50 | $23,113.10 |