- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,924.24 / $8,379.25 / $10,319.70
| Facility | | $6,924.24 | $8,379.25 | $10,319.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.30 / $7,401.08 / $7,529.30
| Facility | | $6,777.30 | $7,401.08 | $7,529.30 |
- 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
- $6,612.35 / $8,548.52 / $13,395.42
| Facility | | $6,612.35 | $8,548.52 | $13,395.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,105.54 / $10,802.34 / $14,256.18
| Facility | | $8,105.54 | $10,802.34 | $14,256.18 |