- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,160.19 / $10,523.00 / $16,246.50
| Facility | | $7,160.19 | $10,523.00 | $16,246.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,531.52 / $16,393.77 / $21,017.66
| Facility | | $11,531.52 | $16,393.77 | $21,017.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,058.54 / $15,580.43 / $19,706.43
| Facility | | $8,058.54 | $15,580.43 | $19,706.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,160.19 / $10,763.20 / $17,210.80
| Facility | | $7,160.19 | $10,763.20 | $17,210.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,373.76 / $14,319.23 / $21,755.08
| Facility | | $8,373.76 | $14,319.23 | $21,755.08 |