- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,042.31 / $14,736.10
| Facility | | $6,303.00 | $7,042.31 | $14,736.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,301.27 / $12,792.43 / $17,164.68
| Facility | | $9,301.27 | $12,792.43 | $17,164.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,620.76 / $10,465.33 / $14,670.67
| Facility | | $7,620.76 | $10,465.33 | $14,670.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,634.56 / $11,622.92 / $14,652.70
| Facility | | $6,634.56 | $11,622.92 | $14,652.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,634.56 / $11,719.67 / $15,367.99
| Facility | | $6,634.56 | $11,719.67 | $15,367.99 |