- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,884.83 / $8,331.54 / $10,261.00
| Facility | | $6,884.83 | $8,331.54 | $10,261.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,738.73 / $7,358.96 / $7,486.44
| Facility | | $6,738.73 | $7,358.96 | $7,486.44 |
- 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
- $6,574.72 / $8,499.86 / $13,319.17
| Facility | | $6,574.72 | $8,499.86 | $13,319.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,059.40 / $10,740.85 / $14,175.03
| Facility | | $8,059.40 | $10,740.85 | $14,175.03 |