- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,522.26 / $15,740.40
| Facility | | $6,303.00 | $7,522.26 | $15,740.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,935.17 / $13,664.27 / $18,334.50
| Facility | | $9,935.17 | $13,664.27 | $18,334.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,140.13 / $11,178.56 / $15,670.51
| Facility | | $8,140.13 | $11,178.56 | $15,670.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,086.72 / $12,415.05 / $15,651.32
| Facility | | $7,086.72 | $12,415.05 | $15,651.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,086.72 / $12,518.40 / $16,415.34
| Facility | | $7,086.72 | $12,518.40 | $16,415.34 |