- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,520.50 / $12,731.20 / $15,679.50
| Facility | | $10,520.50 | $12,731.20 | $15,679.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,297.20 / $11,244.96 / $11,439.76
| Facility | | $10,297.20 | $11,244.96 | $11,439.76 |
- 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
- $10,046.59 / $12,988.34 / $20,352.56
| Facility | | $10,046.59 | $12,988.34 | $20,352.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,315.28 / $16,412.72 / $21,660.36
| Facility | | $12,315.28 | $16,412.72 | $21,660.36 |