- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,680.50 / $16,533.20 / $18,710.00
| Facility | | $10,680.50 | $16,533.20 | $18,710.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,243.17 / $15,492.50 / $20,923.79
| Facility | | $10,243.17 | $15,492.50 | $20,923.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,862.69 / $14,504.41 / $20,739.80
| Facility | | $9,862.69 | $14,504.41 | $20,739.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,654.00 / $16,445.00 / $20,738.00
| Facility | | $10,654.00 | $16,445.00 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $14,831.73 / $25,370.07
| Facility | | $4,008.00 | $14,831.73 | $25,370.07 |