- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,158.11 / $16,642.00
| Facility | | $6,303.00 | $8,158.11 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,774.99 / $14,819.31 / $19,884.31
| Facility | | $10,774.99 | $14,819.31 | $19,884.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,828.21 / $12,123.49 / $16,995.14
| Facility | | $8,828.21 | $12,123.49 | $16,995.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,685.76 / $13,464.49 / $16,974.32
| Facility | | $7,685.76 | $13,464.49 | $16,974.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,685.76 / $13,576.57 / $17,802.93
| Facility | | $7,685.76 | $13,576.57 | $17,802.93 |