- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,727.89 / $9,351.77 / $11,517.50
| Facility | | $7,727.89 | $9,351.77 | $11,517.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,563.90 / $8,260.07 / $8,403.17
| Facility | | $7,563.90 | $8,260.07 | $8,403.17 |
- 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
- $7,379.80 / $9,540.69 / $14,950.13
| Facility | | $7,379.80 | $9,540.69 | $14,950.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,379.80 / $10,394.00 / $14,104.43
| Facility | | $7,379.80 | $10,394.00 | $14,104.43 |