- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.48 / $8,372.27 / $10,311.10
| Facility | | $6,918.48 | $8,372.27 | $10,311.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,771.66 / $7,394.92 / $7,523.02
| Facility | | $6,771.66 | $7,394.92 | $7,523.02 |
- 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
- $6,606.85 / $8,541.40 / $13,384.26
| Facility | | $6,606.85 | $8,541.40 | $13,384.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,098.78 / $10,793.34 / $14,244.30
| Facility | | $8,098.78 | $10,793.34 | $14,244.30 |