- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,303.00 / $8,157.09 / $16,642.00
| Facility | | $6,303.00 | $8,157.09 | $16,642.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,773.64 / $14,817.46 / $19,881.83
| Facility | | $10,773.64 | $14,817.46 | $19,881.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,827.11 / $12,121.97 / $16,993.00
| Facility | | $8,827.11 | $12,121.97 | $16,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,684.80 / $13,462.81 / $16,972.20
| Facility | | $7,684.80 | $13,462.81 | $16,972.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,684.80 / $13,574.88 / $17,800.72
| Facility | | $7,684.80 | $13,574.88 | $17,800.72 |