- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,449.40 / $17,723.50 / $20,056.90
| Facility | | $11,449.40 | $17,723.50 | $20,056.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,800.27 / $17,847.56 / $24,104.48
| Facility | | $11,800.27 | $17,847.56 | $24,104.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,572.71 / $15,866.00 / $22,258.00
| Facility | | $10,572.71 | $15,866.00 | $22,258.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,899.70 / $17,046.00 / $21,242.00
| Facility | | $10,899.70 | $17,046.00 | $21,242.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,536.80 / $27,196.46
| Facility | | $5,274.00 | $16,536.80 | $27,196.46 |