- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,950.60 / $14,544.20
| Facility | | $6,303.00 | $6,950.60 | $14,544.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,180.14 / $12,625.84 / $16,941.15
| Facility | | $9,180.14 | $12,625.84 | $16,941.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,521.52 / $10,329.04 / $14,479.62
| Facility | | $7,521.52 | $10,329.04 | $14,479.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.16 / $11,471.56 / $14,461.88
| Facility | | $6,548.16 | $11,471.56 | $14,461.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,548.16 / $11,567.05 / $15,167.86
| Facility | | $6,548.16 | $11,567.05 | $15,167.86 |