- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,632.01 / $8,025.61 / $9,884.20
| Facility | | $6,632.01 | $8,025.61 | $9,884.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,491.27 / $7,088.72 / $7,211.52
| Facility | | $6,491.27 | $7,088.72 | $7,211.52 |
- 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
- $6,333.28 / $8,187.73 / $12,830.07
| Facility | | $6,333.28 | $8,187.73 | $12,830.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,763.44 / $10,346.43 / $13,654.50
| Facility | | $7,763.44 | $10,346.43 | $13,654.50 |