- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,405.00 / $9,340.62 / $15,162.80
| Facility | | $6,405.00 | $9,340.62 | $15,162.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,465.64 / $11,490.06 / $14,623.33
| Facility | | $10,465.64 | $11,490.06 | $14,623.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,474.89 / $17,734.91 / $22,737.07
| Facility | | $12,474.89 | $17,734.91 | $22,737.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,520.98 / $14,541.10 / $18,391.86
| Facility | | $7,520.98 | $14,541.10 | $18,391.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,682.55 / $10,045.20 / $16,062.70
| Facility | | $6,682.55 | $10,045.20 | $16,062.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,795.12 / $13,957.56 / $20,303.84
| Facility | | $8,795.12 | $13,957.56 | $20,303.84 |