- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,220.50 / $15,821.20 / $17,904.20
| Facility | | $10,220.50 | $15,821.20 | $17,904.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,325.65 / $15,617.25 / $21,092.27
| Facility | | $10,325.65 | $15,617.25 | $21,092.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,437.92 / $14,058.00 / $19,846.58
| Facility | | $9,437.92 | $14,058.00 | $19,846.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,724.00 / $15,604.00 / $20,234.00
| Facility | | $9,724.00 | $15,604.00 | $20,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,761.88 / $24,277.42
| Facility | | $5,274.00 | $14,761.88 | $24,277.42 |