- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,203.02 / $8,716.61 / $10,735.20
| Facility | | $7,203.02 | $8,716.61 | $10,735.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,050.16 / $7,699.06 / $7,832.43
| Facility | | $7,050.16 | $7,699.06 | $7,832.43 |
- 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
- $6,878.57 / $8,892.69 / $13,934.73
| Facility | | $6,878.57 | $8,892.69 | $13,934.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,431.87 / $11,237.25 / $14,830.15
| Facility | | $8,431.87 | $11,237.25 | $14,830.15 |