- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,209.95 / $13,449.30 / $17,677.00
| Facility | | $9,209.95 | $13,449.30 | $17,677.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,934.39 / $10,714.83 / $18,122.68
| Facility | | $3,934.39 | $10,714.83 | $18,122.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,356.06 / $13,509.05 / $22,611.09
| Facility | | $9,356.06 | $13,509.05 | $22,611.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,584.88 / $15,076.28 / $22,012.59
| Facility | | $11,584.88 | $15,076.28 | $22,012.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,584.88 / $14,015.41 / $22,012.59
| Facility | | $11,584.88 | $14,015.41 | $22,012.59 |