- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,142.20 / $18,795.90 / $21,270.60
| Facility | | $12,142.20 | $18,795.90 | $21,270.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.07 / $18,183.03 / $25,008.41
| Facility | | $12,022.07 | $18,183.03 | $25,008.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,204.85 / $17,458.21 / $26,417.32
| Facility | | $11,204.85 | $17,458.21 | $26,417.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,073.00 / $19,129.00 / $26,741.00
| Facility | | $11,073.00 | $19,129.00 | $26,741.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,537.41 / $28,842.07
| Facility | | $5,274.00 | $17,537.41 | $28,842.07 |