- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,929.86 / $16,593.30
| Facility | | $6,303.00 | $7,929.86 | $16,593.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,473.51 / $14,404.68 / $19,327.97
| Facility | | $10,473.51 | $14,404.68 | $19,327.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,581.20 / $11,784.28 / $16,519.63
| Facility | | $8,581.20 | $11,784.28 | $16,519.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,470.72 / $13,087.77 / $16,499.40
| Facility | | $7,470.72 | $13,087.77 | $16,499.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,470.72 / $13,196.72 / $17,304.83
| Facility | | $7,470.72 | $13,196.72 | $17,304.83 |