- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,137.73 / $16,642.00
| Facility | | $6,303.00 | $8,137.73 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,748.07 / $14,782.29 / $19,834.64
| Facility | | $10,748.07 | $14,782.29 | $19,834.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,806.16 / $12,093.20 / $16,952.68
| Facility | | $8,806.16 | $12,093.20 | $16,952.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,666.56 / $13,430.85 / $16,931.91
| Facility | | $7,666.56 | $13,430.85 | $16,931.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,666.56 / $13,542.66 / $17,758.47
| Facility | | $7,666.56 | $13,542.66 | $17,758.47 |