- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,481.20 / $30,835.60 / $37,976.60
| Facility | | $25,481.20 | $30,835.60 | $37,976.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,940.44 / $27,235.94 / $27,707.77
| Facility | | $24,940.44 | $27,235.94 | $27,707.77 |
- 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
- $24,333.43 / $31,458.51 / $49,295.07
| Facility | | $24,333.43 | $31,458.51 | $49,295.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,828.33 / $39,752.55 / $52,462.65
| Facility | | $29,828.33 | $39,752.55 | $52,462.65 |