- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,534.78 / $16,642.00
| Facility | | $6,303.00 | $9,534.78 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,593.25 / $17,320.04 / $23,239.76
| Facility | | $12,593.25 | $17,320.04 | $23,239.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,317.95 / $14,169.31 / $19,863.04
| Facility | | $10,317.95 | $14,169.31 | $19,863.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,982.71 / $15,736.60 / $19,838.71
| Facility | | $8,982.71 | $15,736.60 | $19,838.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,982.71 / $15,867.60 / $20,807.16
| Facility | | $8,982.71 | $15,867.60 | $20,807.16 |