- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,705.68 / $16,124.20
| Facility | | $6,303.00 | $7,705.68 | $16,124.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,177.42 / $13,997.45 / $18,781.56
| Facility | | $10,177.42 | $13,997.45 | $18,781.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,338.62 / $11,451.14 / $16,052.61
| Facility | | $8,338.62 | $11,451.14 | $16,052.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,259.52 / $12,717.77 / $16,032.95
| Facility | | $7,259.52 | $12,717.77 | $16,032.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,259.52 / $12,823.64 / $16,815.62
| Facility | | $7,259.52 | $12,823.64 | $16,815.62 |