- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,227.41 / $16,642.00
| Facility | | $6,303.00 | $8,227.41 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,866.51 / $14,945.18 / $20,053.20
| Facility | | $10,866.51 | $14,945.18 | $20,053.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,903.20 / $12,226.46 / $17,139.49
| Facility | | $8,903.20 | $12,226.46 | $17,139.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,751.04 / $13,578.85 / $17,118.49
| Facility | | $7,751.04 | $13,578.85 | $17,118.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,751.04 / $13,691.89 / $17,954.15
| Facility | | $7,751.04 | $13,691.89 | $17,954.15 |