- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,778.59 / $10,623.30 / $13,083.40
| Facility | | $8,778.59 | $10,623.30 | $13,083.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,592.29 / $9,383.12 / $9,545.68
| Facility | | $8,592.29 | $9,383.12 | $9,545.68 |
- 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
- $8,383.18 / $10,837.86 / $16,982.78
| Facility | | $8,383.18 | $10,837.86 | $16,982.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,276.24 / $13,695.26 / $18,074.05
| Facility | | $10,276.24 | $13,695.26 | $18,074.05 |