- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,836.89 / $11,517.50 / $17,782.00
| Facility | | $7,836.89 | $11,517.50 | $17,782.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,566.01 / $19,286.12 / $24,725.79
| Facility | | $13,566.01 | $19,286.12 | $24,725.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,820.15 / $17,052.93 / $21,568.87
| Facility | | $8,820.15 | $17,052.93 | $21,568.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,836.89 / $11,780.40 / $18,837.30
| Facility | | $7,836.89 | $11,780.40 | $18,837.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,165.16 / $15,672.54 / $23,811.14
| Facility | | $9,165.16 | $15,672.54 | $23,811.14 |