- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,615.17 / $10,425.50 / $12,839.90
| Facility | | $8,615.17 | $10,425.50 | $12,839.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,432.35 / $9,208.45 / $9,367.98
| Facility | | $8,432.35 | $9,208.45 | $9,367.98 |
- 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
- $8,227.12 / $10,636.10 / $16,666.63
| Facility | | $8,227.12 | $10,636.10 | $16,666.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,084.94 / $13,440.31 / $17,737.59
| Facility | | $10,084.94 | $13,440.31 | $17,737.59 |