- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,479.46 / $15,650.80
| Facility | | $6,303.00 | $7,479.46 | $15,650.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,878.64 / $13,586.52 / $18,230.18
| Facility | | $9,878.64 | $13,586.52 | $18,230.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,093.82 / $11,114.96 / $15,581.35
| Facility | | $8,093.82 | $11,114.96 | $15,581.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,046.40 / $12,344.41 / $15,562.27
| Facility | | $7,046.40 | $12,344.41 | $15,562.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,046.40 / $12,447.17 / $16,321.96
| Facility | | $7,046.40 | $12,447.17 | $16,321.96 |