- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,115.30 / $18,754.30 / $21,223.50
| Facility | | $12,115.30 | $18,754.30 | $21,223.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,049.94 / $18,225.18 / $24,614.48
| Facility | | $12,049.94 | $18,225.18 | $24,614.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,187.64 / $16,021.00 / $23,525.97
| Facility | | $11,187.64 | $16,021.00 | $23,525.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,347.00 / $17,558.00 / $22,477.00
| Facility | | $11,347.00 | $17,558.00 | $22,477.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,674.90 / $28,847.54
| Facility | | $5,274.00 | $21,674.90 | $28,847.54 |