- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,679.96 / $11,215.00 / $14,740.40
| Facility | | $7,679.96 | $11,215.00 | $14,740.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,532.94 / $20,515.04 / $34,698.43
| Facility | | $7,532.94 | $20,515.04 | $34,698.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,029.00 / $11,264.86 / $18,854.84
| Facility | | $8,029.00 | $11,264.86 | $18,854.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,660.34 / $12,571.74 / $18,355.75
| Facility | | $9,660.34 | $12,571.74 | $18,355.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,660.34 / $11,687.10 / $18,355.75
| Facility | | $9,660.34 | $11,687.10 | $18,355.75 |