- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,339.86 / $15,358.70
| Facility | | $6,303.00 | $7,339.86 | $15,358.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,694.26 / $13,332.93 / $17,889.91
| Facility | | $9,694.26 | $13,332.93 | $17,889.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,942.75 / $10,907.50 / $15,290.53
| Facility | | $7,942.75 | $10,907.50 | $15,290.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,914.88 / $12,114.01 / $15,271.80
| Facility | | $6,914.88 | $12,114.01 | $15,271.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,914.88 / $12,214.85 / $16,017.31
| Facility | | $6,914.88 | $12,214.85 | $16,017.31 |