- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,874.46 / $16,642.00
| Facility | | $6,303.00 | $8,874.46 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,721.13 / $16,120.58 / $21,630.33
| Facility | | $11,721.13 | $16,120.58 | $21,630.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,603.41 / $13,188.04 / $18,487.47
| Facility | | $9,603.41 | $13,188.04 | $18,487.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,360.64 / $14,646.80 / $18,464.82
| Facility | | $8,360.64 | $14,646.80 | $18,464.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,360.64 / $14,768.72 / $19,366.20
| Facility | | $8,360.64 | $14,768.72 | $19,366.20 |