- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,940.59 / $8,399.03 / $10,344.10
| Facility | | $6,940.59 | $8,399.03 | $10,344.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,793.30 / $7,418.55 / $7,547.07
| Facility | | $6,793.30 | $7,418.55 | $7,547.07 |
- 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
- $6,627.96 / $8,568.70 / $13,427.03
| Facility | | $6,627.96 | $8,568.70 | $13,427.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,124.67 / $10,827.83 / $14,289.82
| Facility | | $8,124.67 | $10,827.83 | $14,289.82 |