- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,308.20 / $16,104.70 / $19,834.30
| Facility | | $13,308.20 | $16,104.70 | $19,834.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,025.82 / $14,224.71 / $14,471.13
| Facility | | $13,025.82 | $14,224.71 | $14,471.13 |
- 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
- $12,708.79 / $16,430.06 / $25,745.69
| Facility | | $12,708.79 | $16,430.06 | $25,745.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,578.65 / $20,761.84 / $27,400.04
| Facility | | $15,578.65 | $20,761.84 | $27,400.04 |