- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,295.50 / $19,033.20 / $21,539.20
| Facility | | $12,295.50 | $19,033.20 | $21,539.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,949.62 / $18,073.46 / $24,409.57
| Facility | | $11,949.62 | $18,073.46 | $24,409.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,354.03 / $16,339.00 / $23,875.87
| Facility | | $11,354.03 | $16,339.00 | $23,875.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,626.02 / $18,304.00 / $22,811.00
| Facility | | $11,626.02 | $18,304.00 | $22,811.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,758.87 / $29,206.28
| Facility | | $5,274.00 | $17,758.87 | $29,206.28 |