- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,655.39 / $16,642.00
| Facility | | $6,303.00 | $8,655.39 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,431.77 / $15,722.61 / $21,096.34
| Facility | | $11,431.77 | $15,722.61 | $21,096.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,366.33 / $12,862.46 / $18,031.06
| Facility | | $9,366.33 | $12,862.46 | $18,031.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,154.24 / $14,285.21 / $18,008.98
| Facility | | $8,154.24 | $14,285.21 | $18,008.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,154.24 / $14,404.13 / $18,888.11
| Facility | | $8,154.24 | $14,404.13 | $18,888.11 |