- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $7,435.64 / $15,559.10
| Facility | | $6,303.00 | $7,435.64 | $15,559.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,820.77 / $13,506.93 / $18,123.38
| Facility | | $9,820.77 | $13,506.93 | $18,123.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,046.40 / $11,049.85 / $15,490.07
| Facility | | $8,046.40 | $11,049.85 | $15,490.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,005.12 / $12,272.09 / $15,471.10
| Facility | | $7,005.12 | $12,272.09 | $15,471.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,005.12 / $12,374.25 / $16,226.34
| Facility | | $7,005.12 | $12,374.25 | $16,226.34 |