- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,405.20 / $16,114.50 / $18,227.70
| Facility | | $10,405.20 | $16,114.50 | $18,227.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,911.93 / $16,503.98 / $22,289.87
| Facility | | $10,911.93 | $16,503.98 | $22,289.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,608.45 / $14,960.73 / $20,502.66
| Facility | | $9,608.45 | $14,960.73 | $20,502.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,735.00 / $17,655.00 / $21,154.00
| Facility | | $11,735.00 | $17,655.00 | $21,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,245.00 / $18,405.00 / $24,775.58
| Facility | | $7,245.00 | $18,405.00 | $24,775.58 |