- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,030.29 / $15,526.70 / $17,570.90
| Facility | | $10,030.29 | $15,526.70 | $17,570.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,223.11 / $15,462.15 / $20,882.80
| Facility | | $10,223.11 | $15,462.15 | $20,882.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,262.23 / $13,621.34 / $19,477.11
| Facility | | $9,262.23 | $13,621.34 | $19,477.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,727.00 / $15,496.00 / $19,893.00
| Facility | | $9,727.00 | $15,496.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,944.61 / $23,882.83
| Facility | | $5,274.00 | $17,944.61 | $23,882.83 |