- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,572.85 / $14,000.90
| Facility | | $6,303.00 | $8,572.85 | $14,000.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,322.75 / $15,572.67 / $20,895.16
| Facility | | $11,322.75 | $15,572.67 | $20,895.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,277.02 / $12,739.81 / $17,859.12
| Facility | | $9,277.02 | $12,739.81 | $17,859.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.48 / $14,148.98 / $17,837.24
| Facility | | $8,076.48 | $14,148.98 | $17,837.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,076.48 / $14,266.77 / $18,707.99
| Facility | | $8,076.48 | $14,266.77 | $18,707.99 |