- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,257.81 / $8,782.92 / $10,816.90
| Facility | | $7,257.81 | $8,782.92 | $10,816.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,103.80 / $7,757.63 / $7,892.02
| Facility | | $7,103.80 | $7,757.63 | $7,892.02 |
- 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
- $6,930.90 / $8,960.34 / $14,040.74
| Facility | | $6,930.90 | $8,960.34 | $14,040.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,179.30 / $9,762.00 / $13,246.48
| Facility | | $7,179.30 | $9,762.00 | $13,246.48 |