- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,859.91 / $14,354.40
| Facility | | $6,303.00 | $6,859.91 | $14,354.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,060.36 / $12,461.10 / $16,720.11
| Facility | | $9,060.36 | $12,461.10 | $16,720.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,423.38 / $10,194.27 / $14,290.69
| Facility | | $7,423.38 | $10,194.27 | $14,290.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,462.72 / $11,321.88 / $14,273.19
| Facility | | $6,462.72 | $11,321.88 | $14,273.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,462.72 / $11,416.13 / $14,969.95
| Facility | | $6,462.72 | $11,416.13 | $14,969.95 |