- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,154.00 / $13,497.80 / $16,623.59
| Facility | | $11,154.00 | $13,497.80 | $16,623.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,917.26 / $11,922.08 / $12,128.62
| Facility | | $10,917.26 | $11,922.08 | $12,128.62 |
- 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
- $10,651.55 / $13,770.44 / $21,578.10
| Facility | | $10,651.55 | $13,770.44 | $21,578.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,056.86 / $17,401.02 / $22,964.66
| Facility | | $13,056.86 | $17,401.02 | $22,964.66 |