- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,258.78 / $8,784.08 / $10,818.30
| Facility | | $7,258.78 | $8,784.08 | $10,818.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,104.74 / $7,758.65 / $7,893.06
| Facility | | $7,104.74 | $7,758.65 | $7,893.06 |
- 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
- $6,931.82 / $8,961.53 / $14,042.59
| Facility | | $6,931.82 | $8,961.53 | $14,042.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,497.14 / $11,324.23 / $14,944.94
| Facility | | $8,497.14 | $11,324.23 | $14,944.94 |