- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,333.74 / $15,345.90
| Facility | | $6,303.00 | $7,333.74 | $15,345.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,686.18 / $13,321.83 / $17,875.02
| Facility | | $9,686.18 | $13,321.83 | $17,875.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,936.13 / $10,898.42 / $15,277.79
| Facility | | $7,936.13 | $10,898.42 | $15,277.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.12 / $12,103.91 / $15,259.08
| Facility | | $6,909.12 | $12,103.91 | $15,259.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,909.12 / $12,204.67 / $16,003.97
| Facility | | $6,909.12 | $12,204.67 | $16,003.97 |