- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,210.50 / $16,181.50 / $26,865.10
| Facility | | $10,210.50 | $16,181.50 | $26,865.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,474.79 / $14,193.80 / $24,044.59
| Facility | | $9,474.79 | $14,193.80 | $24,044.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,947.91 / $17,259.40 / $24,816.91
| Facility | | $13,947.91 | $17,259.40 | $24,816.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,787.00 / $17,327.38 / $42,367.53
| Facility | | $8,787.00 | $17,327.38 | $42,367.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,398.53 / $15,643.19 / $23,094.00
| Facility | | $10,398.53 | $15,643.19 | $23,094.00 |