- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,182.50 / $15,762.30 / $17,837.50
| Facility | | $10,182.50 | $15,762.30 | $17,837.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,483.92 / $15,856.63 / $21,415.58
| Facility | | $10,483.92 | $15,856.63 | $21,415.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,402.78 / $13,996.00 / $19,775.00
| Facility | | $9,402.78 | $13,996.00 | $19,775.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,515.00 / $15,496.00 / $19,893.00
| Facility | | $9,515.00 | $15,496.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,706.92 / $24,187.03
| Facility | | $5,274.00 | $14,706.92 | $24,187.03 |