- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,613.70 / $17,684.50 / $21,779.90
| Facility | | $14,613.70 | $17,684.50 | $21,779.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,303.56 / $15,620.06 / $15,890.65
| Facility | | $14,303.56 | $15,620.06 | $15,890.65 |
- 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
- $13,955.44 / $18,041.73 / $28,271.16
| Facility | | $13,955.44 | $18,041.73 | $28,271.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,106.81 / $22,798.44 / $30,087.80
| Facility | | $17,106.81 | $22,798.44 | $30,087.80 |