- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,615.40 / $14,056.20 / $17,311.30
| Facility | | $11,615.40 | $14,056.20 | $17,311.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,368.89 / $12,415.28 / $12,630.36
| Facility | | $11,368.89 | $12,415.28 | $12,630.36 |
- 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
- $11,092.19 / $14,340.10 / $22,470.76
| Facility | | $11,092.19 | $14,340.10 | $22,470.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,597.00 / $18,120.88 / $23,914.67
| Facility | | $13,597.00 | $18,120.88 | $23,914.67 |