- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,861.21 / $16,642.00
| Facility | | $6,303.00 | $8,861.21 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,703.63 / $16,096.51 / $21,598.05
| Facility | | $11,703.63 | $16,096.51 | $21,598.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,589.08 / $13,168.35 / $18,459.87
| Facility | | $9,589.08 | $13,168.35 | $18,459.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,348.16 / $14,624.93 / $18,437.25
| Facility | | $8,348.16 | $14,624.93 | $18,437.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,348.16 / $14,746.68 / $19,337.30
| Facility | | $8,348.16 | $14,746.68 | $19,337.30 |