- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $6,789.60 / $14,207.30
| Facility | | $6,303.00 | $6,789.60 | $14,207.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,967.49 / $12,333.38 / $16,548.73
| Facility | | $8,967.49 | $12,333.38 | $16,548.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,347.29 / $10,089.78 / $14,144.22
| Facility | | $7,347.29 | $10,089.78 | $14,144.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,396.48 / $11,205.83 / $14,126.89
| Facility | | $6,396.48 | $11,205.83 | $14,126.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,396.48 / $11,299.12 / $14,816.51
| Facility | | $6,396.48 | $11,299.12 | $14,816.51 |