- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,004.00 / $18,257.70 / $23,632.40
| Facility | | $7,004.00 | $18,257.70 | $23,632.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,356.00 / $16,948.61 / $17,242.22
| Facility | | $5,356.00 | $16,948.61 | $17,242.22 |
- 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
- $5,700.00 / $18,756.46 / $30,675.75
| Facility | | $5,700.00 | $18,756.46 | $30,675.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,700.00 / $19,302.45 / $30,675.75
| Facility | | $5,700.00 | $19,302.45 | $30,675.75 |