- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,747.12 / $9,375.03 / $11,546.10
| Facility | | $7,747.12 | $9,375.03 | $11,546.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,582.71 / $8,280.62 / $8,424.07
| Facility | | $7,582.71 | $8,280.62 | $8,424.07 |
- 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
- $7,398.16 / $9,564.42 / $14,987.32
| Facility | | $7,398.16 | $9,564.42 | $14,987.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,068.79 / $12,086.08 / $15,950.37
| Facility | | $9,068.79 | $12,086.08 | $15,950.37 |