- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,014.43 / $16,642.00
| Facility | | $6,303.00 | $8,014.43 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,585.22 / $14,558.31 / $19,534.11
| Facility | | $10,585.22 | $14,558.31 | $19,534.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,672.74 / $11,909.97 / $16,695.82
| Facility | | $8,672.74 | $11,909.97 | $16,695.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,550.40 / $13,158.00 / $16,675.37
| Facility | | $7,550.40 | $13,158.00 | $16,675.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,550.40 / $13,337.47 / $17,489.40
| Facility | | $7,550.40 | $13,337.47 | $17,489.40 |