- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,638.95 / $11,664.40 / $14,365.70
| Facility | | $9,638.95 | $11,664.40 | $14,365.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,434.40 / $10,302.74 / $10,481.21
| Facility | | $9,434.40 | $10,302.74 | $10,481.21 |
- 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
- $9,204.79 / $11,900.04 / $18,647.21
| Facility | | $9,204.79 | $11,900.04 | $18,647.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,283.38 / $15,037.49 / $19,845.43
| Facility | | $11,283.38 | $15,037.49 | $19,845.43 |