- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,078.90 / $16,642.00
| Facility | | $6,303.00 | $10,078.90 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,311.94 / $18,308.49 / $24,566.04
| Facility | | $13,311.94 | $18,308.49 | $24,566.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,906.81 / $14,977.94 / $20,996.61
| Facility | | $10,906.81 | $14,977.94 | $20,996.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,495.36 / $16,634.68 / $20,970.90
| Facility | | $9,495.36 | $16,634.68 | $20,970.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,495.36 / $16,773.16 / $21,994.62
| Facility | | $9,495.36 | $16,773.16 | $21,994.62 |