- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,512.31 / $10,301.00 / $12,686.60
| Facility | | $8,512.31 | $10,301.00 | $12,686.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,331.67 / $9,098.51 / $9,256.12
| Facility | | $8,331.67 | $9,098.51 | $9,256.12 |
- 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
- $8,128.89 / $10,509.11 / $16,467.64
| Facility | | $8,128.89 | $10,509.11 | $16,467.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,964.53 / $13,279.84 / $17,525.82
| Facility | | $9,964.53 | $13,279.84 | $17,525.82 |