- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,345.30 / $13,729.30 / $16,908.70
| Facility | | $11,345.30 | $13,729.30 | $16,908.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,104.50 / $12,126.56 / $12,336.63
| Facility | | $11,104.50 | $12,126.56 | $12,336.63 |
- 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
- $10,834.24 / $14,006.61 / $21,948.18
| Facility | | $10,834.24 | $14,006.61 | $21,948.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,280.79 / $17,699.46 / $23,358.52
| Facility | | $13,280.79 | $17,699.46 | $23,358.52 |