- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,827.30 / $14,286.20
| Facility | | $6,303.00 | $6,827.30 | $14,286.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,017.29 / $12,401.87 / $16,640.63
| Facility | | $9,017.29 | $12,401.87 | $16,640.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,388.09 / $10,145.81 / $14,222.76
| Facility | | $7,388.09 | $10,145.81 | $14,222.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,432.00 / $11,268.06 / $14,205.34
| Facility | | $6,432.00 | $11,268.06 | $14,205.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,432.00 / $11,361.86 / $14,898.79
| Facility | | $6,432.00 | $11,361.86 | $14,898.79 |