- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,175.84 / $10,546.00 / $16,282.00
| Facility | | $7,175.84 | $10,546.00 | $16,282.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,156.84 / $18,704.41 / $23,980.02
| Facility | | $13,156.84 | $18,704.41 | $23,980.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.15 / $15,614.49 / $19,749.50
| Facility | | $8,076.15 | $15,614.49 | $19,749.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,175.84 / $10,786.70 / $17,248.40
| Facility | | $7,175.84 | $10,786.70 | $17,248.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,392.06 / $14,350.53 / $21,802.63
| Facility | | $8,392.06 | $14,350.53 | $21,802.63 |