- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,019.70 / $20,154.20 / $22,807.70
| Facility | | $13,019.70 | $20,154.20 | $22,807.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,965.02 / $19,609.22 / $26,483.73
| Facility | | $12,965.02 | $19,609.22 | $26,483.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.71 / $16,560.74 / $25,282.00
| Facility | | $12,022.71 | $16,560.74 | $25,282.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,008.00 / $19,082.00 / $24,316.00
| Facility | | $12,008.00 | $19,082.00 | $24,316.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $18,080.00 / $30,926.33
| Facility | | $5,274.00 | $18,080.00 | $30,926.33 |