- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,463.81 / $16,642.00
| Facility | | $6,303.00 | $8,463.81 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,178.75 / $15,374.61 / $20,629.41
| Facility | | $11,178.75 | $15,374.61 | $20,629.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,159.03 / $12,577.78 / $17,631.98
| Facility | | $9,159.03 | $12,577.78 | $17,631.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,973.76 / $13,969.03 / $17,610.38
| Facility | | $7,973.76 | $13,969.03 | $17,610.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,139.88 / $12,247.20 / $17,962.56
| Facility | | $8,139.88 | $12,247.20 | $17,962.56 |