- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,959.20 / $16,972.50 / $19,198.20
| Facility | | $10,959.20 | $16,972.50 | $19,198.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,269.92 / $15,532.96 / $20,978.43
| Facility | | $10,269.92 | $15,532.96 | $20,978.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,120.03 / $15,616.28 / $21,280.95
| Facility | | $10,120.03 | $15,616.28 | $21,280.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,654.00 / $17,265.00 / $20,738.00
| Facility | | $10,654.00 | $17,265.00 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,249.70 / $26,032.03
| Facility | | $5,274.00 | $17,249.70 | $26,032.03 |