- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $10,550.70 / $17,231.09
| Facility | | $6,303.00 | $10,550.70 | $17,231.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,935.08 / $19,165.50 / $25,715.98
| Facility | | $13,935.08 | $19,165.50 | $25,715.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,417.36 / $15,679.06 / $21,979.47
| Facility | | $11,417.36 | $15,679.06 | $21,979.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,939.84 / $17,413.36 / $21,952.55
| Facility | | $9,939.84 | $17,413.36 | $21,952.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,939.84 / $17,558.31 / $23,024.19
| Facility | | $9,939.84 | $17,558.31 | $23,024.19 |