- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,827.37 / $11,892.40 / $14,646.50
| Facility | | $9,827.37 | $11,892.40 | $14,646.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,618.82 / $10,504.13 / $10,686.10
| Facility | | $9,618.82 | $10,504.13 | $10,686.10 |
- 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
- $9,384.70 / $12,132.66 / $19,011.71
| Facility | | $9,384.70 | $12,132.66 | $19,011.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,503.94 / $15,331.43 / $20,233.36
| Facility | | $11,503.94 | $15,331.43 | $20,233.36 |