- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,713.50 / $18,132.30 / $20,519.59
| Facility | | $11,713.50 | $18,132.30 | $20,519.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,608.76 / $16,045.44 / $21,670.58
| Facility | | $10,608.76 | $16,045.44 | $21,670.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,809.28 / $15,866.00 / $22,612.00
| Facility | | $10,809.28 | $15,866.00 | $22,612.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,817.37 / $16,687.00 / $21,636.00
| Facility | | $10,817.37 | $16,687.00 | $21,636.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,158.00 / $17,185.59 / $27,823.86
| Facility | | $4,158.00 | $17,185.59 | $27,823.86 |