- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,942.45 / $14,527.10
| Facility | | $6,303.00 | $6,942.45 | $14,527.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,169.37 / $12,611.03 / $16,921.28
| Facility | | $9,169.37 | $12,611.03 | $16,921.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,512.70 / $10,316.93 / $14,462.64
| Facility | | $7,512.70 | $10,316.93 | $14,462.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,540.48 / $11,458.10 / $14,444.92
| Facility | | $6,540.48 | $11,458.10 | $14,444.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,540.48 / $11,553.49 / $15,150.07
| Facility | | $6,540.48 | $11,553.49 | $15,150.07 |