- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,762.70 / $17,577.30
| Facility | | $6,303.00 | $10,762.70 | $17,577.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,215.02 / $19,550.53 / $26,232.59
| Facility | | $14,215.02 | $19,550.53 | $26,232.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,646.72 / $15,994.04 / $22,421.01
| Facility | | $11,646.72 | $15,994.04 | $22,421.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,139.52 / $17,763.16 / $22,393.55
| Facility | | $10,139.52 | $17,763.16 | $22,393.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,139.52 / $17,911.04 / $23,486.72
| Facility | | $10,139.52 | $17,911.04 | $23,486.72 |