- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,169.10 / $14,726.20 / $18,136.50
| Facility | | $12,169.10 | $14,726.20 | $18,136.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,910.85 / $13,007.12 / $13,232.45
| Facility | | $11,910.85 | $13,007.12 | $13,232.45 |
- 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
- $11,620.96 / $15,023.70 / $23,541.94
| Facility | | $11,620.96 | $15,023.70 | $23,541.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,245.17 / $18,984.70 / $25,054.69
| Facility | | $14,245.17 | $18,984.70 | $25,054.69 |