- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,458.71 / $16,642.00
| Facility | | $6,303.00 | $8,458.71 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,172.02 / $15,365.36 / $20,616.99
| Facility | | $11,172.02 | $15,365.36 | $20,616.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,153.51 / $12,570.20 / $17,621.36
| Facility | | $9,153.51 | $12,570.20 | $17,621.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,968.96 / $13,960.62 / $17,599.78
| Facility | | $7,968.96 | $13,960.62 | $17,599.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,968.96 / $14,076.84 / $18,458.93
| Facility | | $7,968.96 | $14,076.84 | $18,458.93 |