- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,657.60 / $18,045.70 / $20,421.59
| Facility | | $11,657.60 | $18,045.70 | $20,421.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,662.26 / $16,126.36 / $21,779.86
| Facility | | $10,662.26 | $16,126.36 | $21,779.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,764.94 / $15,831.28 / $22,637.09
| Facility | | $10,764.94 | $15,831.28 | $22,637.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,259.50 / $17,256.00 / $21,457.00
| Facility | | $11,259.50 | $17,256.00 | $21,457.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $20,855.96 / $27,757.60
| Facility | | $5,274.00 | $20,855.96 | $27,757.60 |