- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,139.77 / $16,642.00
| Facility | | $6,303.00 | $8,139.77 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,750.76 / $14,785.99 / $19,839.59
| Facility | | $10,750.76 | $14,785.99 | $19,839.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,808.37 / $12,096.23 / $16,956.93
| Facility | | $8,808.37 | $12,096.23 | $16,956.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,668.48 / $13,434.22 / $16,936.16
| Facility | | $7,668.48 | $13,434.22 | $16,936.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,668.48 / $13,546.05 / $17,762.91
| Facility | | $7,668.48 | $13,546.05 | $17,762.91 |