- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,712.01 / $11,752.80 / $14,474.60
| Facility | | $9,712.01 | $11,752.80 | $14,474.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,505.91 / $10,380.83 / $10,560.67
| Facility | | $9,505.91 | $10,380.83 | $10,560.67 |
- 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
- $9,274.54 / $11,990.24 / $18,788.55
| Facility | | $9,274.54 | $11,990.24 | $18,788.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,368.91 / $15,151.47 / $19,995.86
| Facility | | $11,368.91 | $15,151.47 | $19,995.86 |