- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,152.36 / $14,966.30
| Facility | | $6,303.00 | $7,152.36 | $14,966.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,446.62 / $12,992.34 / $17,432.91
| Facility | | $9,446.62 | $12,992.34 | $17,432.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,739.85 / $10,628.87 / $14,899.93
| Facility | | $7,739.85 | $10,628.87 | $14,899.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,738.24 / $11,804.55 / $14,881.68
| Facility | | $6,738.24 | $11,804.55 | $14,881.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,738.24 / $11,902.82 / $15,608.15
| Facility | | $6,738.24 | $11,902.82 | $15,608.15 |