- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,677.79 / $16,642.00
| Facility | | $6,303.00 | $8,677.79 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,461.38 / $15,763.33 / $21,150.98
| Facility | | $11,461.38 | $15,763.33 | $21,150.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,390.59 / $12,895.78 / $18,077.75
| Facility | | $9,390.59 | $12,895.78 | $18,077.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,175.36 / $14,322.21 / $18,055.62
| Facility | | $8,175.36 | $14,322.21 | $18,055.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,175.36 / $14,441.43 / $18,937.03
| Facility | | $8,175.36 | $14,441.43 | $18,937.03 |