- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,614.92 / $11,635.30 / $14,329.90
| Facility | | $9,614.92 | $11,635.30 | $14,329.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,410.87 / $10,277.06 / $10,455.09
| Facility | | $9,410.87 | $10,277.06 | $10,455.09 |
- 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
- $9,181.84 / $11,870.37 / $18,600.72
| Facility | | $9,181.84 | $11,870.37 | $18,600.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,255.25 / $15,000.00 / $19,795.96
| Facility | | $11,255.25 | $15,000.00 | $19,795.96 |