- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,662.70 / $17,743.80 / $21,853.00
| Facility | | $14,662.70 | $17,743.80 | $21,853.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,351.55 / $15,672.46 / $15,943.96
| Facility | | $14,351.55 | $15,672.46 | $15,943.96 |
- 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
- $14,002.25 / $18,102.25 / $28,366.00
| Facility | | $14,002.25 | $18,102.25 | $28,366.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,164.20 / $22,874.92 / $30,188.74
| Facility | | $17,164.20 | $22,874.92 | $30,188.74 |