- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,129.94 / $14,919.40
| Facility | | $6,303.00 | $7,129.94 | $14,919.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,417.01 / $12,951.62 / $17,378.28
| Facility | | $9,417.01 | $12,951.62 | $17,378.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,715.59 / $10,595.56 / $14,853.23
| Facility | | $7,715.59 | $10,595.56 | $14,853.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,717.12 / $11,767.55 / $14,835.04
| Facility | | $6,717.12 | $11,767.55 | $14,835.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,717.12 / $11,865.51 / $15,559.23
| Facility | | $6,717.12 | $11,865.51 | $15,559.23 |