- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,762.37 / $16,642.00
| Facility | | $6,303.00 | $8,762.37 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,573.08 / $15,916.96 / $21,357.13
| Facility | | $11,573.08 | $15,916.96 | $21,357.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,482.12 / $13,021.47 / $18,253.96
| Facility | | $9,482.12 | $13,021.47 | $18,253.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.04 / $14,461.80 / $18,231.59
| Facility | | $8,255.04 | $14,461.80 | $18,231.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,255.04 / $14,582.18 / $19,121.59
| Facility | | $8,255.04 | $14,582.18 | $19,121.59 |