- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,807.00 / $9,772.00 / $15,863.00
| Facility | | $6,807.00 | $9,772.00 | $15,863.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,338.70 / $18,962.95 / $24,311.47
| Facility | | $13,338.70 | $18,962.95 | $24,311.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,868.31 / $15,212.65 / $19,241.25
| Facility | | $7,868.31 | $15,212.65 | $19,241.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,991.17 / $10,509.10 / $16,804.50
| Facility | | $6,991.17 | $10,509.10 | $16,804.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,176.09 / $13,981.22 / $21,241.54
| Facility | | $8,176.09 | $13,981.22 | $21,241.54 |