- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,535.91 / $20,456.80 / $25,820.10
| Facility | | $3,535.91 | $20,456.80 | $25,820.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,517.61 / $18,517.61 / $18,838.40
| Facility | | $18,517.61 | $18,517.61 | $18,838.40 |
- 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
- $1,850.00 / $20,492.82 / $31,619.60
| Facility | | $1,850.00 | $20,492.82 | $31,619.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,239.00 / $21,361.48 / $33,515.51
| Facility | | $2,239.00 | $21,361.48 | $33,515.51 |