- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,212.12 / $16,642.00
| Facility | | $6,303.00 | $8,212.12 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,846.32 / $14,917.41 / $20,015.93
| Facility | | $10,846.32 | $14,917.41 | $20,015.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,886.66 / $12,203.74 / $17,107.65
| Facility | | $8,886.66 | $12,203.74 | $17,107.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,736.64 / $13,553.63 / $17,086.68
| Facility | | $7,736.64 | $13,553.63 | $17,086.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,736.64 / $13,666.45 / $17,920.80
| Facility | | $7,736.64 | $13,666.45 | $17,920.80 |