- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,810.81 / $8,241.98 / $10,150.70
| Facility | | $6,810.81 | $8,241.98 | $10,150.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,666.28 / $7,279.84 / $7,405.95
| Facility | | $6,666.28 | $7,279.84 | $7,405.95 |
- 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
- $6,504.03 / $8,408.48 / $13,175.97
| Facility | | $6,504.03 | $8,408.48 | $13,175.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,972.75 / $10,625.37 / $14,022.63
| Facility | | $7,972.75 | $10,625.37 | $14,022.63 |