- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,014.00 / $18,270.40 / $24,517.50
| Facility | | $11,014.00 | $18,270.40 | $24,517.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,110.73 / $15,093.41 / $15,330.04
| Facility | | $13,110.73 | $15,093.41 | $15,330.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,019.31 / $15,393.84 / $24,630.73
| Facility | | $9,019.31 | $15,393.84 | $24,630.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,044.02 / $14,710.50 / $33,737.06
| Facility | | $9,044.02 | $14,710.50 | $33,737.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,737.68 / $14,490.82 / $20,528.00
| Facility | | $10,737.68 | $14,490.82 | $20,528.00 |