- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,927.30 / $21,694.40 / $26,718.40
| Facility | | $17,927.30 | $21,694.40 | $26,718.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,546.84 / $19,161.84 / $19,493.80
| Facility | | $17,546.84 | $19,161.84 | $19,493.80 |
- 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
- $17,119.78 / $22,132.63 / $34,681.55
| Facility | | $17,119.78 | $22,132.63 | $34,681.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,985.72 / $27,967.91 / $36,910.10
| Facility | | $20,985.72 | $27,967.91 | $36,910.10 |