- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,483.00 / $17,775.50 / $20,115.80
| Facility | | $11,483.00 | $17,775.50 | $20,115.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,746.76 / $17,766.64 / $23,995.19
| Facility | | $11,746.76 | $17,766.64 | $23,995.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,603.71 / $15,866.00 / $22,298.06
| Facility | | $10,603.71 | $15,866.00 | $22,298.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,558.00 / $21,304.00
| Facility | | $11,347.00 | $17,558.00 | $21,304.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,946.09 / $27,276.21
| Facility | | $5,274.00 | $15,946.09 | $27,276.21 |