- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $16,595.87 / $19,054.61
| Facility | | $10,715.19 | $16,595.87 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $23,988.33
| Facility | | $12,022.64 | $17,782.79 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $15,488.17 / $21,379.62
| Facility | | $10,000.00 | $15,488.17 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $17,378.01 / $20,892.96
| Facility | | $11,748.98 | $17,378.01 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $18,197.01 / $25,703.96
| Facility | | $4,073.80 | $18,197.01 | $25,703.96 |