- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,853.33 / $11,923.80 / $14,685.20
| Facility | | $9,853.33 | $11,923.80 | $14,685.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,644.23 / $10,531.88 / $10,714.33
| Facility | | $9,644.23 | $10,531.88 | $10,714.33 |
- 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
- $9,409.50 / $12,164.70 / $19,061.93
| Facility | | $9,409.50 | $12,164.70 | $19,061.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,534.33 / $15,371.93 / $20,286.80
| Facility | | $11,534.33 | $15,371.93 | $20,286.80 |