- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,643.54 / $8,039.57 / $9,901.39
| Facility | | $6,643.54 | $8,039.57 | $9,901.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,502.56 / $7,101.05 / $7,224.07
| Facility | | $6,502.56 | $7,101.05 | $7,224.07 |
- 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
- $6,344.30 / $8,201.96 / $12,852.39
| Facility | | $6,344.30 | $8,201.96 | $12,852.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,776.95 / $10,364.43 / $13,678.25
| Facility | | $7,776.95 | $10,364.43 | $13,678.25 |