- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,905.50 / $16,881.50 / $19,104.09
| Facility | | $10,905.50 | $16,881.50 | $19,104.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,365.57 / $17,190.09 / $23,216.52
| Facility | | $11,365.57 | $17,190.09 | $23,216.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,070.42 / $14,904.00 / $21,438.00
| Facility | | $10,070.42 | $14,904.00 | $21,438.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,809.00 / $16,623.00 / $21,590.00
| Facility | | $10,809.00 | $16,623.00 | $21,590.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $19,510.41 / $25,966.79
| Facility | | $5,274.00 | $19,510.41 | $25,966.79 |