- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,402.71 / $10,168.40 / $12,523.20
| Facility | | $8,402.71 | $10,168.40 | $12,523.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,224.41 / $8,981.37 / $9,136.96
| Facility | | $8,224.41 | $8,981.37 | $9,136.96 |
- 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
- $8,024.24 / $10,373.82 / $16,255.64
| Facility | | $8,024.24 | $10,373.82 | $16,255.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,836.25 / $13,108.88 / $17,300.18
| Facility | | $9,836.25 | $13,108.88 | $17,300.18 |