- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,394.79 / $11,368.90 / $14,001.80
| Facility | | $9,394.79 | $11,368.90 | $14,001.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,195.42 / $10,041.76 / $10,215.71
| Facility | | $9,195.42 | $10,041.76 | $10,215.71 |
- 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
- $8,971.61 / $11,598.60 / $18,174.84
| Facility | | $8,971.61 | $11,598.60 | $18,174.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,997.56 / $14,656.57 / $19,342.72
| Facility | | $10,997.56 | $14,656.57 | $19,342.72 |