- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,480.84 / $9,052.79 / $11,149.30
| Facility | | $7,480.84 | $9,052.79 | $11,149.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,322.08 / $7,996.01 / $8,134.52
| Facility | | $7,322.08 | $7,996.01 | $8,134.52 |
- 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
- $7,143.88 / $9,235.68 / $14,472.19
| Facility | | $7,143.88 | $9,235.68 | $14,472.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,757.08 / $11,670.67 / $15,402.13
| Facility | | $8,757.08 | $11,670.67 | $15,402.13 |