- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,654.83 / $9,263.36 / $11,408.60
| Facility | | $7,654.83 | $9,263.36 | $11,408.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,492.39 / $8,181.98 / $8,323.71
| Facility | | $7,492.39 | $8,181.98 | $8,323.71 |
- 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
- $7,310.03 / $9,450.49 / $14,808.79
| Facility | | $7,310.03 | $9,450.49 | $14,808.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,960.76 / $11,942.11 / $15,760.37
| Facility | | $8,960.76 | $11,942.11 | $15,760.37 |