- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,101.90 / $15,637.50 / $17,696.40
| Facility | | $10,101.90 | $15,637.50 | $17,696.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,273.26 / $15,538.01 / $20,985.26
| Facility | | $10,273.26 | $15,538.01 | $20,985.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,328.37 / $13,718.62 / $19,616.21
| Facility | | $9,328.37 | $13,718.62 | $19,616.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,602.00 / $15,496.00 / $20,234.00
| Facility | | $9,602.00 | $15,496.00 | $20,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,590.53 / $23,995.62
| Facility | | $5,274.00 | $14,590.53 | $23,995.62 |