- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,214.16 / $16,642.00
| Facility | | $6,303.00 | $8,214.16 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,849.01 / $14,921.11 / $20,020.91
| Facility | | $10,849.01 | $14,921.11 | $20,020.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,888.86 / $12,206.77 / $17,111.89
| Facility | | $8,888.86 | $12,206.77 | $17,111.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,738.56 / $13,556.99 / $17,090.93
| Facility | | $7,738.56 | $13,556.99 | $17,090.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,738.56 / $13,669.84 / $17,925.25
| Facility | | $7,738.56 | $13,669.84 | $17,925.25 |