- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,651.31 / $16,642.00
| Facility | | $6,303.00 | $8,651.31 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,426.39 / $15,715.20 / $21,086.41
| Facility | | $11,426.39 | $15,715.20 | $21,086.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,361.92 / $12,856.41 / $18,022.57
| Facility | | $9,361.92 | $12,856.41 | $18,022.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,150.40 / $14,278.48 / $18,000.50
| Facility | | $8,150.40 | $14,278.48 | $18,000.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,150.40 / $14,397.34 / $18,879.21
| Facility | | $8,150.40 | $14,397.34 | $18,879.21 |