- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,339.00 / $12,177.40 / $16,005.30
| Facility | | $8,339.00 | $12,177.40 | $16,005.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,556.34 / $9,685.25 / $16,381.29
| Facility | | $3,556.34 | $9,685.25 | $16,381.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,471.28 / $12,231.54 / $20,472.83
| Facility | | $8,471.28 | $12,231.54 | $20,472.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,489.33 / $13,650.56 / $19,930.93
| Facility | | $10,489.33 | $13,650.56 | $19,930.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,489.33 / $12,690.01 / $19,930.93
| Facility | | $10,489.33 | $12,690.01 | $19,930.93 |