- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,662.52 / $9,272.66 / $11,420.10
| Facility | | $7,662.52 | $9,272.66 | $11,420.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,499.91 / $8,190.20 / $8,332.09
| Facility | | $7,499.91 | $8,190.20 | $8,332.09 |
- 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
- $7,317.38 / $9,459.98 / $14,823.67
| Facility | | $7,317.38 | $9,459.98 | $14,823.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,969.77 / $11,954.11 / $15,776.20
| Facility | | $8,969.77 | $11,954.11 | $15,776.20 |