- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,532.80 / $16,304.60 / $18,451.20
| Facility | | $10,532.80 | $16,304.60 | $18,451.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,096.04 / $15,269.97 / $20,623.25
| Facility | | $10,096.04 | $15,269.97 | $20,623.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,726.27 / $14,303.78 / $20,452.93
| Facility | | $9,726.27 | $14,303.78 | $20,452.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,971.00 / $15,496.00 / $20,662.00
| Facility | | $9,971.00 | $15,496.00 | $20,662.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,212.88 / $25,019.14
| Facility | | $5,274.00 | $15,212.88 | $25,019.14 |