- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,894.44 / $8,343.19 / $10,275.29
| Facility | | $6,894.44 | $8,343.19 | $10,275.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,748.13 / $7,369.23 / $7,496.89
| Facility | | $6,748.13 | $7,369.23 | $7,496.89 |
- 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
- $6,583.90 / $8,511.73 / $13,337.77
| Facility | | $6,583.90 | $8,511.73 | $13,337.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,070.65 / $10,755.85 / $14,194.82
| Facility | | $8,070.65 | $10,755.85 | $14,194.82 |