- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,309.57 / $7,585.78 / $17,782.79
| Facility | | $6,309.57 | $7,585.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $12,302.69 / $16,218.10
| Facility | | $8,511.38 | $12,302.69 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $10,000.00 / $13,803.84
| Facility | | $8,128.31 | $10,000.00 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $10,000.00 / $13,182.57
| Facility | | $6,025.60 | $10,000.00 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,025.60 / $9,332.54 / $13,803.84
| Facility | | $6,025.60 | $9,332.54 | $13,803.84 |