- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,320.79 / $16,642.00
| Facility | | $6,303.00 | $9,320.79 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,310.62 / $16,931.33 / $22,718.18
| Facility | | $12,310.62 | $16,931.33 | $22,718.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,086.40 / $13,851.30 / $19,417.25
| Facility | | $10,086.40 | $13,851.30 | $19,417.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,781.12 / $14,447.69 / $19,393.47
| Facility | | $8,781.12 | $14,447.69 | $19,393.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,781.12 / $15,511.48 / $20,340.18
| Facility | | $8,781.12 | $15,511.48 | $20,340.18 |