- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $9,045.66 / $16,642.00
| Facility | | $6,303.00 | $9,045.66 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,947.23 / $16,431.55 / $22,047.59
| Facility | | $11,947.23 | $16,431.55 | $22,047.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,788.67 / $13,442.44 / $18,844.09
| Facility | | $9,788.67 | $13,442.44 | $18,844.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,521.92 / $14,929.34 / $18,821.02
| Facility | | $8,521.92 | $14,929.34 | $18,821.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,521.92 / $15,053.62 / $19,739.78
| Facility | | $8,521.92 | $15,053.62 | $19,739.78 |