- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,896.53 / $16,642.00
| Facility | | $6,303.00 | $9,896.53 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,071.03 / $17,977.15 / $24,121.46
| Facility | | $13,071.03 | $17,977.15 | $24,121.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,709.42 / $14,706.88 / $20,616.63
| Facility | | $10,709.42 | $14,706.88 | $20,616.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,323.52 / $16,333.64 / $20,591.38
| Facility | | $9,323.52 | $16,333.64 | $20,591.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,517.76 / $14,320.34 / $21,003.17
| Facility | | $9,517.76 | $14,320.34 | $21,003.17 |