- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,770.68 / $6,983.29 / $8,600.50
| Facility | | $5,770.68 | $6,983.29 | $8,600.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,648.22 / $6,168.08 / $6,274.94
| Facility | | $5,648.22 | $6,168.08 | $6,274.94 |
- 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
- $5,510.75 / $7,124.36 / $11,163.78
| Facility | | $5,510.75 | $7,124.36 | $11,163.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,755.18 / $9,002.70 / $11,881.14
| Facility | | $6,755.18 | $9,002.70 | $11,881.14 |