- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,298.08 / $15,271.30
| Facility | | $6,303.00 | $7,298.08 | $15,271.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,639.08 / $13,257.04 / $17,788.09
| Facility | | $9,639.08 | $13,257.04 | $17,788.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,897.54 / $10,845.42 / $15,203.49
| Facility | | $7,897.54 | $10,845.42 | $15,203.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,875.52 / $12,045.05 / $15,184.87
| Facility | | $6,875.52 | $12,045.05 | $15,184.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,875.52 / $12,145.32 / $15,926.14
| Facility | | $6,875.52 | $12,145.32 | $15,926.14 |