- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,122.45 / $16,642.00
| Facility | | $6,303.00 | $8,122.45 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,727.88 / $14,754.52 / $19,797.38
| Facility | | $10,727.88 | $14,754.52 | $19,797.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,789.62 / $12,070.49 / $16,920.84
| Facility | | $8,789.62 | $12,070.49 | $16,920.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,652.16 / $13,405.63 / $16,900.11
| Facility | | $7,652.16 | $13,405.63 | $16,900.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,652.16 / $13,517.22 / $17,725.11
| Facility | | $7,652.16 | $13,517.22 | $17,725.11 |