- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,040.50 / $17,023.59 / $22,074.20
| Facility | | $11,040.50 | $17,023.59 | $22,074.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,754.98 / $16,897.00 / $22,935.55
| Facility | | $9,754.98 | $16,897.00 | $22,935.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,817.00 / $4,817.00 / $4,817.00
| Facility | | $4,817.00 | $4,817.00 | $4,817.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,807.00 / $12,678.00 / $19,567.00
| Facility | | $8,807.00 | $12,678.00 | $19,567.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,098.00 / $18,065.00 / $20,917.25
| Facility | | $6,098.00 | $18,065.00 | $20,917.25 |