- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,590.17 / $16,642.00
| Facility | | $6,303.00 | $8,590.17 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,345.63 / $15,604.14 / $20,937.39
| Facility | | $11,345.63 | $15,604.14 | $20,937.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,295.76 / $12,765.55 / $17,895.20
| Facility | | $9,295.76 | $12,765.55 | $17,895.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,092.80 / $14,177.57 / $17,873.29
| Facility | | $8,092.80 | $14,177.57 | $17,873.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,092.80 / $14,295.59 / $18,745.79
| Facility | | $8,092.80 | $14,295.59 | $18,745.79 |