- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,408.79 / $16,642.00
| Facility | | $6,303.00 | $8,408.79 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,106.07 / $15,274.66 / $20,495.29
| Facility | | $11,106.07 | $15,274.66 | $20,495.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,099.48 / $12,496.00 / $17,517.34
| Facility | | $9,099.48 | $12,496.00 | $17,517.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.92 / $13,878.21 / $17,495.89
| Facility | | $7,921.92 | $13,878.21 | $17,495.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,086.96 / $12,592.55 / $17,845.78
| Facility | | $8,086.96 | $12,592.55 | $17,845.78 |