- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,823.88 / $16,371.50
| Facility | | $6,303.00 | $7,823.88 | $16,371.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,333.54 / $14,212.17 / $19,069.66
| Facility | | $10,333.54 | $14,212.17 | $19,069.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,466.53 / $11,626.80 / $16,298.86
| Facility | | $8,466.53 | $11,626.80 | $16,298.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,370.88 / $12,912.86 / $16,278.90
| Facility | | $7,370.88 | $12,912.86 | $16,278.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,370.88 / $13,020.35 / $17,073.57
| Facility | | $7,370.88 | $13,020.35 | $17,073.57 |