- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,936.74 / $8,394.37 / $10,338.40
| Facility | | $6,936.74 | $8,394.37 | $10,338.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,789.53 / $7,414.44 / $7,542.88
| Facility | | $6,789.53 | $7,414.44 | $7,542.88 |
- 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
- $6,624.29 / $8,563.95 / $13,419.60
| Facility | | $6,624.29 | $8,563.95 | $13,419.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,120.16 / $10,821.84 / $14,281.91
| Facility | | $8,120.16 | $10,821.84 | $14,281.91 |