- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,937.90 / $16,931.70 / $19,160.90
| Facility | | $10,937.90 | $16,931.70 | $19,160.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,652.23 / $16,111.19 / $22,158.86
| Facility | | $10,652.23 | $16,111.19 | $22,158.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,100.40 / $15,585.98 / $23,797.26
| Facility | | $10,100.40 | $15,585.98 | $23,797.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,642.00 / $17,321.00 / $25,764.00
| Facility | | $10,642.00 | $17,321.00 | $25,764.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $15,189.20 / $25,981.52
| Facility | | $5,274.00 | $15,189.20 | $25,981.52 |