- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,685.10 / $11,720.20 / $14,434.50
| Facility | | $9,685.10 | $11,720.20 | $14,434.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,479.57 / $10,352.06 / $10,531.40
| Facility | | $9,479.57 | $10,352.06 | $10,531.40 |
- 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
- $9,248.85 / $11,957.01 / $18,736.48
| Facility | | $9,248.85 | $11,957.01 | $18,736.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,337.40 / $15,109.48 / $19,940.43
| Facility | | $11,337.40 | $15,109.48 | $19,940.43 |