- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,248.50 / $18,960.50 / $21,456.80
| Facility | | $12,248.50 | $18,960.50 | $21,456.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,087.83 / $18,282.50 / $24,691.89
| Facility | | $12,087.83 | $18,282.50 | $24,691.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,310.62 / $16,208.00 / $23,784.60
| Facility | | $11,310.62 | $16,208.00 | $23,784.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,595.00 / $18,008.00 / $22,724.00
| Facility | | $11,595.00 | $18,008.00 | $22,724.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,913.17 / $29,164.67
| Facility | | $5,274.00 | $21,913.17 | $29,164.67 |