- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,951.16 / $8,411.82 / $10,359.90
| Facility | | $6,951.16 | $8,411.82 | $10,359.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,803.65 / $7,429.85 / $7,558.56
| Facility | | $6,803.65 | $7,429.85 | $7,558.56 |
- 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
- $6,638.06 / $8,581.75 / $13,447.49
| Facility | | $6,638.06 | $8,581.75 | $13,447.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,137.04 / $10,844.33 / $14,311.60
| Facility | | $8,137.04 | $10,844.33 | $14,311.60 |