- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,622.30 / $16,443.20 / $18,608.09
| Facility | | $10,622.30 | $16,443.20 | $18,608.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,034.54 / $16,689.41 / $22,540.32
| Facility | | $11,034.54 | $16,689.41 | $22,540.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,808.95 / $14,876.00 / $20,814.00
| Facility | | $9,808.95 | $14,876.00 | $20,814.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,102.91 / $16,817.00 / $20,738.00
| Facility | | $11,102.91 | $16,817.00 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,003.83 / $25,292.57
| Facility | | $5,274.00 | $19,003.83 | $25,292.57 |