- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,793.01 / $10,640.70 / $13,104.90
| Facility | | $8,793.01 | $10,640.70 | $13,104.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,606.41 / $9,398.54 / $9,561.36
| Facility | | $8,606.41 | $9,398.54 | $9,561.36 |
- 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
- $8,396.95 / $10,855.66 / $17,010.68
| Facility | | $8,396.95 | $10,855.66 | $17,010.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,293.12 / $13,717.76 / $18,103.74
| Facility | | $10,293.12 | $13,717.76 | $18,103.74 |