- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,789.10 / $19,797.30 / $22,403.80
| Facility | | $12,789.10 | $19,797.30 | $22,403.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,515.84 / $18,929.84 / $25,566.18
| Facility | | $12,515.84 | $18,929.84 | $25,566.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,809.80 / $16,507.00 / $24,834.30
| Facility | | $11,809.80 | $16,507.00 | $24,834.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,107.00 / $18,304.00 / $23,681.00
| Facility | | $12,107.00 | $18,304.00 | $23,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $22,880.28 / $30,451.81
| Facility | | $5,274.00 | $22,880.28 | $30,451.81 |