- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,191.74 / $16,642.00
| Facility | | $6,303.00 | $8,191.74 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,819.40 / $14,880.39 / $19,966.27
| Facility | | $10,819.40 | $14,880.39 | $19,966.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,864.61 / $12,173.46 / $17,065.18
| Facility | | $8,864.61 | $12,173.46 | $17,065.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,717.44 / $13,519.99 / $17,044.29
| Facility | | $7,717.44 | $13,519.99 | $17,044.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,878.22 / $11,853.51 / $17,385.14
| Facility | | $7,878.22 | $11,853.51 | $17,385.14 |