- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,834.40 / $18,319.50 / $20,731.40
| Facility | | $11,834.40 | $18,319.50 | $20,731.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,473.89 / $15,841.46 / $21,787.88
| Facility | | $10,473.89 | $15,841.46 | $21,787.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,920.83 / $16,863.41 / $25,747.69
| Facility | | $10,920.83 | $16,863.41 | $25,747.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,362.93 / $17,209.00 / $25,651.00
| Facility | | $10,362.93 | $17,209.00 | $25,651.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,172.32 / $28,178.65
| Facility | | $5,274.00 | $21,172.32 | $28,178.65 |