- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,396.24 / $8,950.43 / $11,023.20
| Facility | | $7,396.24 | $8,950.43 | $11,023.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,239.28 / $7,905.59 / $8,042.54
| Facility | | $7,239.28 | $7,905.59 | $8,042.54 |
- 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
- $7,063.09 / $9,131.24 / $14,308.53
| Facility | | $7,063.09 | $9,131.24 | $14,308.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,658.06 / $11,538.69 / $15,227.96
| Facility | | $8,658.06 | $11,538.69 | $15,227.96 |