- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,681.22 / $16,073.00
| Facility | | $6,303.00 | $7,681.22 | $16,073.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,145.12 / $13,953.03 / $18,721.95
| Facility | | $10,145.12 | $13,953.03 | $18,721.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,312.15 / $11,414.79 / $16,001.67
| Facility | | $8,312.15 | $11,414.79 | $16,001.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,236.48 / $12,677.41 / $15,982.07
| Facility | | $7,236.48 | $12,677.41 | $15,982.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,236.48 / $12,782.94 / $16,762.25
| Facility | | $7,236.48 | $12,782.94 | $16,762.25 |