- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,332.54 / $10,083.50 / $12,418.60
| Facility | | $8,332.54 | $10,083.50 | $12,418.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,155.72 / $8,906.37 / $9,060.66
| Facility | | $8,155.72 | $8,906.37 | $9,060.66 |
- 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
- $7,957.22 / $10,287.18 / $16,119.88
| Facility | | $7,957.22 | $10,287.18 | $16,119.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,754.10 / $12,999.40 / $17,155.71
| Facility | | $9,754.10 | $12,999.40 | $17,155.71 |