- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,458.80 / $17,857.00 / $20,929.40
| Facility | | $12,458.80 | $17,857.00 | $20,929.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,932.90 / $18,048.16 / $24,375.42
| Facility | | $11,932.90 | $18,048.16 | $24,375.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,032.61 / $15,913.00 / $23,199.98
| Facility | | $11,032.61 | $15,913.00 | $23,199.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,558.00 / $22,166.00
| Facility | | $11,347.00 | $17,558.00 | $22,166.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,204.00 / $28,359.21
| Facility | | $5,274.00 | $15,204.00 | $28,359.21 |