- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,433.80 / $10,168.60 / $16,865.00
| Facility | | $7,433.80 | $10,168.60 | $16,865.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,554.44 / $9,226.96 / $11,527.11
| Facility | | $6,554.44 | $9,226.96 | $11,527.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,125.96 / $9,177.04 / $15,546.12
| Facility | | $6,125.96 | $9,177.04 | $15,546.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,756.03 / $10,834.87 / $15,579.22
| Facility | | $8,756.03 | $10,834.87 | $15,579.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,443.13 / $10,921.96 / $17,437.16
| Facility | | $5,443.13 | $10,921.96 | $17,437.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,443.13 / $10,385.48 / $14,596.28
| Facility | | $5,443.13 | $10,385.48 | $14,596.28 |