- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,508.21 / $11,506.20 / $14,170.80
| Facility | | $9,508.21 | $11,506.20 | $14,170.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,306.44 / $10,163.00 / $10,339.06
| Facility | | $9,306.44 | $10,163.00 | $10,339.06 |
- 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
- $9,079.94 / $11,738.64 / $18,394.29
| Facility | | $9,079.94 | $11,738.64 | $18,394.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,130.34 / $14,833.53 / $19,576.27
| Facility | | $11,130.34 | $14,833.53 | $19,576.27 |