- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,569.28 / $9,159.82 / $11,281.10
| Facility | | $7,569.28 | $9,159.82 | $11,281.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,408.65 / $8,090.54 / $8,230.69
| Facility | | $7,408.65 | $8,090.54 | $8,230.69 |
- 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
- $7,228.33 / $9,344.86 / $14,643.28
| Facility | | $7,228.33 | $9,344.86 | $14,643.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,860.61 / $11,808.64 / $15,584.22
| Facility | | $8,860.61 | $11,808.64 | $15,584.22 |