- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,758.90 / $16,654.50 / $18,847.20
| Facility | | $10,758.90 | $16,654.50 | $18,847.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,742.51 / $16,247.74 / $21,943.79
| Facility | | $10,742.51 | $16,247.74 | $21,943.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,935.04 / $14,610.80 / $20,891.93
| Facility | | $9,935.04 | $14,610.80 | $20,891.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,451.00 / $16,070.00 / $20,738.00
| Facility | | $10,451.00 | $16,070.00 | $20,738.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,940.52 / $25,617.68
| Facility | | $5,274.00 | $14,940.52 | $25,617.68 |