- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,369.00 / $8,995.73 / $16,642.00
| Facility | | $2,369.00 | $8,995.73 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,344.92 / $15,233.46 / $20,725.68
| Facility | | $10,344.92 | $15,233.46 | $20,725.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,644.59 / $11,940.75 / $18,740.08
| Facility | | $9,644.59 | $11,940.75 | $18,740.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,474.87 / $14,846.93 / $18,717.13
| Facility | | $8,474.87 | $14,846.93 | $18,717.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,474.87 / $14,970.52 / $19,630.82
| Facility | | $8,474.87 | $14,970.52 | $19,630.82 |