- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,053.16 / $16,642.00
| Facility | | $6,303.00 | $8,053.16 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,636.36 / $14,628.65 / $19,628.49
| Facility | | $10,636.36 | $14,628.65 | $19,628.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,714.64 / $11,967.51 / $16,776.49
| Facility | | $8,714.64 | $11,967.51 | $16,776.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,586.88 / $13,291.27 / $16,755.93
| Facility | | $7,586.88 | $13,291.27 | $16,755.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,586.88 / $13,401.91 / $17,573.90
| Facility | | $7,586.88 | $13,401.91 | $17,573.90 |