- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,506.48 / $14,722.70 / $16,765.00
| Facility | | $9,506.48 | $14,722.70 | $16,765.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,127.45 / $13,805.01 / $18,644.71
| Facility | | $9,127.45 | $13,805.01 | $18,644.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,778.54 / $13,400.00 / $18,460.00
| Facility | | $8,778.54 | $13,400.00 | $18,460.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,719.00 / $15,496.00 / $19,893.00
| Facility | | $10,719.00 | $15,496.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,007.54 / $22,635.66
| Facility | | $5,274.00 | $17,007.54 | $22,635.66 |