- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.30 / $16,559.20 / $18,739.40
| Facility | | $10,697.30 | $16,559.20 | $18,739.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,656.69 / $16,117.93 / $21,768.48
| Facility | | $10,656.69 | $16,117.93 | $21,768.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,878.19 / $15,243.10 / $20,772.40
| Facility | | $9,878.19 | $15,243.10 | $20,772.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,237.00 / $15,624.00 / $20,738.00
| Facility | | $10,237.00 | $15,624.00 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,450.51 / $25,409.94
| Facility | | $5,274.00 | $15,450.51 | $25,409.94 |