- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,633.90 / $12,868.40 / $15,848.50
| Facility | | $10,633.90 | $12,868.40 | $15,848.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,408.24 / $11,366.21 / $11,563.11
| Facility | | $10,408.24 | $11,366.21 | $11,563.11 |
- 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
- $10,154.92 / $13,128.38 / $20,572.00
| Facility | | $10,154.92 | $13,128.38 | $20,572.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,448.07 / $16,589.68 / $21,893.91
| Facility | | $12,448.07 | $16,589.68 | $21,893.91 |