- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,442.30 / $18,687.30 / $23,014.90
| Facility | | $15,442.30 | $18,687.30 | $23,014.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,114.62 / $16,505.75 / $16,791.70
| Facility | | $15,114.62 | $16,505.75 | $16,791.70 |
- 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
- $14,746.75 / $19,064.75 / $29,874.22
| Facility | | $14,746.75 | $19,064.75 | $29,874.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,076.82 / $24,091.18 / $31,793.87
| Facility | | $18,076.82 | $24,091.18 | $31,793.87 |