- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $15,488.17 / $17,782.79
| Facility | | $12,022.64 | $15,488.17 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $12,589.25 / $18,197.01
| Facility | | $11,220.18 | $12,589.25 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $13,803.84 / $16,595.87
| Facility | | $11,748.98 | $13,803.84 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $17,782.79 / $22,387.21
| Facility | | $10,964.78 | $17,782.79 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $14,454.40 / $20,892.96
| Facility | | $12,882.50 | $14,454.40 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $17,378.01 / $22,908.68
| Facility | | $1,862.09 | $17,378.01 | $22,908.68 |