- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,353.10 / $15,386.40
| Facility | | $6,303.00 | $7,353.10 | $15,386.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,711.75 / $13,357.00 / $17,922.21
| Facility | | $9,711.75 | $13,357.00 | $17,922.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,957.08 / $10,927.19 / $15,318.12
| Facility | | $7,957.08 | $10,927.19 | $15,318.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,927.36 / $12,135.87 / $15,299.36
| Facility | | $6,927.36 | $12,135.87 | $15,299.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,927.36 / $12,236.89 / $16,046.22
| Facility | | $6,927.36 | $12,236.89 | $16,046.22 |