- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,253.97 / $8,778.26 / $10,811.20
| Facility | | $7,253.97 | $8,778.26 | $10,811.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,100.03 / $7,753.52 / $7,887.83
| Facility | | $7,100.03 | $7,753.52 | $7,887.83 |
- 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
- $6,927.23 / $8,955.59 / $14,033.30
| Facility | | $6,927.23 | $8,955.59 | $14,033.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,491.51 / $11,316.74 / $14,935.04
| Facility | | $8,491.51 | $11,316.74 | $14,935.04 |