- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,873.50 / $17,338.80 / $24,306.60
| Facility | | $10,873.50 | $17,338.80 | $24,306.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,407.12 / $15,407.12 / $15,407.12
| Facility | | $15,407.12 | $15,407.12 | $15,407.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,761.01 / $15,640.63 / $23,695.90
| Facility | | $9,761.01 | $15,640.63 | $23,695.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,491.99 / $16,242.00 / $25,158.91
| Facility | | $10,491.99 | $16,242.00 | $25,158.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.04 / $16,242.00 / $23,809.03
| Facility | | $9,549.04 | $16,242.00 | $23,809.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,207.23 / $18,911.99 / $27,017.48
| Facility | | $8,207.23 | $18,911.99 | $27,017.48 |