- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,430.19 / $16,642.00
| Facility | | $6,303.00 | $8,430.19 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,134.33 / $15,313.53 / $20,547.45
| Facility | | $11,134.33 | $15,313.53 | $20,547.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,122.64 / $12,527.80 / $17,561.91
| Facility | | $9,122.64 | $12,527.80 | $17,561.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,942.08 / $13,913.53 / $17,540.41
| Facility | | $7,942.08 | $13,913.53 | $17,540.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,942.08 / $14,029.35 / $18,396.66
| Facility | | $7,942.08 | $14,029.35 | $18,396.66 |