- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,378.69 / $10,139.29 / $12,487.40
| Facility | | $8,378.69 | $10,139.29 | $12,487.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,200.87 / $8,955.69 / $9,110.83
| Facility | | $8,200.87 | $8,955.69 | $9,110.83 |
- 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
- $8,001.29 / $10,344.15 / $16,209.15
| Facility | | $8,001.29 | $10,344.15 | $16,209.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,808.11 / $13,071.39 / $17,250.71
| Facility | | $9,808.11 | $13,071.39 | $17,250.71 |