- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,761.54 / $9,392.48 / $11,567.60
| Facility | | $7,761.54 | $9,392.48 | $11,567.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,596.83 / $8,296.04 / $8,439.75
| Facility | | $7,596.83 | $8,296.04 | $8,439.75 |
- 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
- $7,411.93 / $9,582.21 / $15,015.22
| Facility | | $7,411.93 | $9,582.21 | $15,015.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,085.67 / $12,108.58 / $15,980.06
| Facility | | $9,085.67 | $12,108.58 | $15,980.06 |