- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,186.43 / $9,906.66 / $12,200.90
| Facility | | $8,186.43 | $9,906.66 | $12,200.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,012.70 / $8,750.19 / $8,901.77
| Facility | | $8,012.70 | $8,750.19 | $8,901.77 |
- 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
- $7,817.69 / $10,106.79 / $15,837.21
| Facility | | $7,817.69 | $10,106.79 | $15,837.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,583.04 / $12,771.45 / $16,854.87
| Facility | | $9,583.04 | $12,771.45 | $16,854.87 |