- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,114.30 / $16,642.00
| Facility | | $6,303.00 | $8,114.30 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,717.12 / $14,739.71 / $19,777.50
| Facility | | $10,717.12 | $14,739.71 | $19,777.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,780.79 / $12,058.37 / $16,903.86
| Facility | | $8,780.79 | $12,058.37 | $16,903.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,644.48 / $13,392.17 / $16,883.15
| Facility | | $7,644.48 | $13,392.17 | $16,883.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,644.48 / $13,503.66 / $17,707.32
| Facility | | $7,644.48 | $13,503.66 | $17,707.32 |