- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,385.67 / $8,937.62 / $11,007.40
| Facility | | $7,385.67 | $8,937.62 | $11,007.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,228.93 / $7,894.28 / $8,031.04
| Facility | | $7,228.93 | $7,894.28 | $8,031.04 |
- 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
- $7,052.99 / $9,118.18 / $14,288.08
| Facility | | $7,052.99 | $9,118.18 | $14,288.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,645.68 / $11,522.20 / $15,206.19
| Facility | | $8,645.68 | $11,522.20 | $15,206.19 |