- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,965.52 / $16,642.00
| Facility | | $6,303.00 | $7,965.52 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,520.62 / $14,469.46 / $19,414.90
| Facility | | $10,520.62 | $14,469.46 | $19,414.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,619.81 / $11,837.28 / $16,593.93
| Facility | | $8,619.81 | $11,837.28 | $16,593.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,504.32 / $13,146.63 / $16,573.59
| Facility | | $7,504.32 | $13,146.63 | $16,573.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,660.66 / $11,526.17 / $16,905.04
| Facility | | $7,660.66 | $11,526.17 | $16,905.04 |