- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,635.37 / $15,977.00
| Facility | | $6,303.00 | $7,635.37 | $15,977.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,084.56 / $13,869.73 / $18,610.18
| Facility | | $10,084.56 | $13,869.73 | $18,610.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,262.53 / $11,346.65 / $15,906.14
| Facility | | $8,262.53 | $11,346.65 | $15,906.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,193.28 / $12,601.73 / $15,886.66
| Facility | | $7,193.28 | $12,601.73 | $15,886.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,193.28 / $12,706.63 / $16,662.18
| Facility | | $7,193.28 | $12,706.63 | $16,662.18 |