- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,388.41 / $16,642.00
| Facility | | $6,303.00 | $8,388.41 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,079.15 / $15,237.64 / $20,445.62
| Facility | | $11,079.15 | $15,237.64 | $20,445.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,077.43 / $12,465.72 / $17,474.89
| Facility | | $9,077.43 | $12,465.72 | $17,474.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,902.72 / $13,844.58 / $17,453.49
| Facility | | $7,902.72 | $13,844.58 | $17,453.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,902.72 / $13,959.83 / $18,305.50
| Facility | | $7,902.72 | $13,959.83 | $18,305.50 |