- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,427.00 / $17,688.80 / $20,017.70
| Facility | | $11,427.00 | $17,688.80 | $20,017.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,472.57 / $17,351.93 / $23,435.10
| Facility | | $11,472.57 | $17,351.93 | $23,435.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,552.04 / $15,544.00 / $22,189.39
| Facility | | $10,552.04 | $15,544.00 | $22,189.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,439.00 / $21,342.00
| Facility | | $11,347.00 | $17,439.00 | $21,342.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $18,991.70 / $27,143.29
| Facility | | $5,274.00 | $18,991.70 | $27,143.29 |