- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,747.58 / $11,795.90 / $14,527.60
| Facility | | $9,747.58 | $11,795.90 | $14,527.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,540.73 / $10,418.85 / $10,599.34
| Facility | | $9,540.73 | $10,418.85 | $10,599.34 |
- 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
- $9,308.52 / $12,034.15 / $18,857.36
| Facility | | $9,308.52 | $12,034.15 | $18,857.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,410.54 / $15,206.96 / $20,069.09
| Facility | | $11,410.54 | $15,206.96 | $20,069.09 |