- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,030.37 / $16,642.00
| Facility | | $6,303.00 | $9,030.37 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,927.05 / $16,403.78 / $22,010.34
| Facility | | $11,927.05 | $16,403.78 | $22,010.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.12 / $13,419.73 / $18,812.25
| Facility | | $9,772.12 | $13,419.73 | $18,812.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,507.52 / $14,904.11 / $18,789.21
| Facility | | $8,507.52 | $14,904.11 | $18,789.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,507.52 / $15,028.18 / $19,706.43
| Facility | | $8,507.52 | $15,028.18 | $19,706.43 |