- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,828.98 / $16,382.20
| Facility | | $6,303.00 | $7,828.98 | $16,382.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,340.27 / $14,221.43 / $19,082.08
| Facility | | $10,340.27 | $14,221.43 | $19,082.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,472.04 / $11,634.37 / $16,309.47
| Facility | | $8,472.04 | $11,634.37 | $16,309.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,375.68 / $12,921.27 / $16,289.50
| Facility | | $7,375.68 | $12,921.27 | $16,289.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,375.68 / $13,028.83 / $17,084.68
| Facility | | $7,375.68 | $13,028.83 | $17,084.68 |