- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,438.00 / $16,261.80 / $20,027.70
| Facility | | $13,438.00 | $16,261.80 | $20,027.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,152.84 / $14,363.42 / $14,612.25
| Facility | | $13,152.84 | $14,363.42 | $14,612.25 |
- 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
- $12,832.72 / $16,590.28 / $25,996.75
| Facility | | $12,832.72 | $16,590.28 | $25,996.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,730.57 / $20,964.31 / $27,667.24
| Facility | | $15,730.57 | $20,964.31 | $27,667.24 |