- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,038.39 / $9,727.51 / $11,980.20
| Facility | | $8,038.39 | $9,727.51 | $11,980.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,867.81 / $8,591.95 / $8,740.79
| Facility | | $7,867.81 | $8,591.95 | $8,740.79 |
- 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
- $7,676.32 / $9,924.02 / $15,550.81
| Facility | | $7,676.32 | $9,924.02 | $15,550.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,409.76 / $12,540.49 / $16,550.07
| Facility | | $9,409.76 | $12,540.49 | $16,550.07 |