- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,676.94 / $9,290.11 / $11,441.50
| Facility | | $7,676.94 | $9,290.11 | $11,441.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,514.03 / $8,205.62 / $8,347.77
| Facility | | $7,514.03 | $8,205.62 | $8,347.77 |
- 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
- $7,331.15 / $9,477.78 / $14,851.56
| Facility | | $7,331.15 | $9,477.78 | $14,851.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,986.65 / $11,976.60 / $15,805.89
| Facility | | $8,986.65 | $11,976.60 | $15,805.89 |