- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,233.29 / $11,173.50 / $13,761.10
| Facility | | $9,233.29 | $11,173.50 | $13,761.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,037.34 / $9,869.14 / $10,040.11
| Facility | | $9,037.34 | $9,869.14 | $10,040.11 |
- 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
- $8,817.39 / $11,399.21 / $17,862.41
| Facility | | $8,817.39 | $11,399.21 | $17,862.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,808.51 / $14,404.62 / $19,010.22
| Facility | | $10,808.51 | $14,404.62 | $19,010.22 |