- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,248.79 / $16,642.00
| Facility | | $6,303.00 | $8,248.79 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,894.77 / $14,984.05 / $20,105.36
| Facility | | $10,894.77 | $14,984.05 | $20,105.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,926.36 / $12,258.26 / $17,184.07
| Facility | | $8,926.36 | $12,258.26 | $17,184.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,771.20 / $13,614.17 / $17,163.02
| Facility | | $7,771.20 | $13,614.17 | $17,163.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,771.20 / $13,727.50 / $18,000.84
| Facility | | $7,771.20 | $13,727.50 | $18,000.84 |