- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,911.95 / $11,994.80 / $14,772.60
| Facility | | $9,911.95 | $11,994.80 | $14,772.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,701.62 / $10,594.55 / $10,778.09
| Facility | | $9,701.62 | $10,594.55 | $10,778.09 |
- 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
- $9,465.50 / $12,237.09 / $19,175.37
| Facility | | $9,465.50 | $12,237.09 | $19,175.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,602.97 / $15,463.41 / $20,407.53
| Facility | | $11,602.97 | $15,463.41 | $20,407.53 |