- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,909.40 / $18,435.50 / $20,862.70
| Facility | | $11,909.40 | $18,435.50 | $20,862.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,905.04 / $18,006.02 / $24,318.50
| Facility | | $11,905.04 | $18,006.02 | $24,318.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,997.47 / $15,866.00 / $23,126.09
| Facility | | $10,997.47 | $15,866.00 | $23,126.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,475.00 / $22,052.00
| Facility | | $11,347.00 | $17,475.00 | $22,052.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,201.18 / $28,289.10
| Facility | | $5,274.00 | $17,201.18 | $28,289.10 |