- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,733.85 / $16,642.00
| Facility | | $6,303.00 | $8,733.85 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,535.40 / $15,865.14 / $21,287.59
| Facility | | $11,535.40 | $15,865.14 | $21,287.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,451.24 / $12,979.07 / $18,194.52
| Facility | | $9,451.24 | $12,979.07 | $18,194.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,228.16 / $14,414.71 / $18,172.23
| Facility | | $8,228.16 | $14,414.71 | $18,172.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,228.16 / $14,534.70 / $19,059.33
| Facility | | $8,228.16 | $14,534.70 | $19,059.33 |