- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,695.21 / $9,312.21 / $11,468.80
| Facility | | $7,695.21 | $9,312.21 | $11,468.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,531.90 / $8,225.14 / $8,367.62
| Facility | | $7,531.90 | $8,225.14 | $8,367.62 |
- 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
- $7,348.59 / $9,500.33 / $14,886.90
| Facility | | $7,348.59 | $9,500.33 | $14,886.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,008.03 / $12,005.10 / $15,843.50
| Facility | | $9,008.03 | $12,005.10 | $15,843.50 |