- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,266.12 / $16,642.00
| Facility | | $6,303.00 | $8,266.12 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,917.65 / $15,015.51 / $20,147.58
| Facility | | $10,917.65 | $15,015.51 | $20,147.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,945.10 / $12,284.00 / $17,220.15
| Facility | | $8,945.10 | $12,284.00 | $17,220.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,787.52 / $13,642.76 / $17,199.06
| Facility | | $7,787.52 | $13,642.76 | $17,199.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,787.52 / $13,756.33 / $18,038.65
| Facility | | $7,787.52 | $13,756.33 | $18,038.65 |