- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,309.48 / $10,055.60 / $12,384.30
| Facility | | $8,309.48 | $10,055.60 | $12,384.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,133.14 / $8,881.70 / $9,035.57
| Facility | | $8,133.14 | $8,881.70 | $9,035.57 |
- 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
- $7,935.19 / $10,258.70 / $16,075.25
| Facility | | $7,935.19 | $10,258.70 | $16,075.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,727.09 / $12,963.41 / $17,108.20
| Facility | | $9,727.09 | $12,963.41 | $17,108.20 |