- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,810.31 / $10,661.60 / $13,130.70
| Facility | | $8,810.31 | $10,661.60 | $13,130.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,623.35 / $9,417.04 / $9,580.17
| Facility | | $8,623.35 | $9,417.04 | $9,580.17 |
- 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
- $8,413.46 / $10,877.02 / $17,044.15
| Facility | | $8,413.46 | $10,877.02 | $17,044.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.37 / $13,744.75 / $18,139.37
| Facility | | $10,313.37 | $13,744.75 | $18,139.37 |