- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,763.46 / $9,394.81 / $11,570.50
| Facility | | $7,763.46 | $9,394.81 | $11,570.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,598.71 / $8,298.09 / $8,441.84
| Facility | | $7,598.71 | $8,298.09 | $8,441.84 |
- 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
- $7,413.77 / $9,584.60 / $15,018.94
| Facility | | $7,413.77 | $9,584.60 | $15,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,087.92 / $12,111.58 / $15,984.02
| Facility | | $9,087.92 | $12,111.58 | $15,984.02 |