- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,814.87 / $11,877.30 / $14,627.90
| Facility | | $9,814.87 | $11,877.30 | $14,627.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,606.59 / $10,490.78 / $10,672.51
| Facility | | $9,606.59 | $10,490.78 | $10,672.51 |
- 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
- $9,372.78 / $12,117.23 / $18,987.54
| Facility | | $9,372.78 | $12,117.23 | $18,987.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,489.31 / $15,311.94 / $20,207.63
| Facility | | $11,489.31 | $15,311.94 | $20,207.63 |