- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,251.90 / $15,869.70 / $17,959.09
| Facility | | $10,251.90 | $15,869.70 | $17,959.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,295.56 / $15,571.73 / $21,030.80
| Facility | | $10,295.56 | $15,571.73 | $21,030.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,465.00 / $13,922.28 / $19,907.43
| Facility | | $9,465.00 | $13,922.28 | $19,907.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,705.00 / $15,496.00 / $20,280.00
| Facility | | $9,705.00 | $15,496.00 | $20,280.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $14,236.47 / $24,351.86
| Facility | | $5,274.00 | $14,236.47 | $24,351.86 |