- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $11,664.50 / $19,050.09
| Facility | | $6,303.00 | $11,664.50 | $19,050.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,406.11 / $21,188.68 / $28,430.64
| Facility | | $15,406.11 | $21,188.68 | $28,430.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,622.61 / $17,334.18 / $24,299.69
| Facility | | $12,622.61 | $17,334.18 | $24,299.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,989.12 / $19,251.56 / $24,269.93
| Facility | | $10,989.12 | $19,251.56 | $24,269.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,989.12 / $19,411.82 / $25,454.69
| Facility | | $10,989.12 | $19,411.82 | $25,454.69 |