- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,603.30 / $19,509.70 / $22,078.30
| Facility | | $12,603.30 | $19,509.70 | $22,078.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,691.95 / $19,196.20 / $25,925.92
| Facility | | $12,691.95 | $19,196.20 | $25,925.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,638.24 / $16,389.25 / $24,473.53
| Facility | | $11,638.24 | $16,389.25 | $24,473.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,848.91 / $18,201.00 / $23,382.00
| Facility | | $11,848.91 | $18,201.00 | $23,382.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,547.90 / $30,009.44
| Facility | | $5,274.00 | $22,547.90 | $30,009.44 |