- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,363.20 / $17,598.20 / $20,453.00
| Facility | | $11,363.20 | $17,598.20 | $20,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,903.01 / $16,490.49 / $22,680.54
| Facility | | $10,903.01 | $16,490.49 | $22,680.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,493.13 / $16,192.00 / $24,722.56
| Facility | | $10,493.13 | $16,192.00 | $24,722.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,804.00 / $18,940.00 / $25,651.00
| Facility | | $12,804.00 | $18,940.00 | $25,651.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $16,412.32 / $26,991.75
| Facility | | $5,274.00 | $16,412.32 | $26,991.75 |