- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,216.45 / $14,371.90 / $18,313.00
| Facility | | $9,216.45 | $14,371.90 | $18,313.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,541.94 / $22,388.31 / $27,325.26
| Facility | | $9,541.94 | $22,388.31 | $27,325.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,240.40 / $14,722.20 / $17,340.84
| Facility | | $8,240.40 | $14,722.20 | $17,340.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,844.54 / $14,930.64 / $20,916.73
| Facility | | $7,844.54 | $14,930.64 | $20,916.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,187.96 / $16,287.25 / $20,916.73
| Facility | | $14,187.96 | $16,287.25 | $20,916.73 |