- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,986.10 / $20,102.20 / $22,748.80
| Facility | | $12,986.10 | $20,102.20 | $22,748.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,044.16 / $19,728.91 / $26,645.39
| Facility | | $13,044.16 | $19,728.91 | $26,645.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,991.70 / $16,887.00 / $25,216.80
| Facility | | $11,991.70 | $16,887.00 | $25,216.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,293.00 / $18,607.00 / $24,092.00
| Facility | | $12,293.00 | $18,607.00 | $24,092.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $23,232.69 / $30,920.83
| Facility | | $5,274.00 | $23,232.69 | $30,920.83 |