- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,174.70 / $18,846.09 / $21,327.40
| Facility | | $12,174.70 | $18,846.09 | $21,327.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,373.17 / $18,714.06 / $25,274.75
| Facility | | $12,373.17 | $18,714.06 | $25,274.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,242.41 / $16,176.00 / $23,641.16
| Facility | | $11,242.41 | $16,176.00 | $23,641.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,692.10 / $17,982.00 / $22,695.00
| Facility | | $11,692.10 | $17,982.00 | $22,695.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $21,781.02 / $28,988.78
| Facility | | $5,274.00 | $21,781.02 | $28,988.78 |