- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,266.21 / $10,003.20 / $12,319.80
| Facility | | $8,266.21 | $10,003.20 | $12,319.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,090.80 / $8,835.46 / $8,988.53
| Facility | | $8,090.80 | $8,835.46 | $8,988.53 |
- 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
- $7,893.88 / $10,205.29 / $15,991.56
| Facility | | $7,893.88 | $10,205.29 | $15,991.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,676.45 / $12,895.92 / $17,019.14
| Facility | | $9,676.45 | $12,895.92 | $17,019.14 |