- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,132.28 / $16,642.00
| Facility | | $6,303.00 | $9,132.28 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,061.63 / $16,588.89 / $22,258.70
| Facility | | $12,061.63 | $16,588.89 | $22,258.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,882.40 / $13,571.16 / $19,024.53
| Facility | | $9,882.40 | $13,571.16 | $19,024.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,603.52 / $15,072.29 / $19,001.23
| Facility | | $8,603.52 | $15,072.29 | $19,001.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,603.52 / $15,197.76 / $19,928.80
| Facility | | $8,603.52 | $15,197.76 | $19,928.80 |