- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,168.50 / $17,288.59 / $19,564.80
| Facility | | $11,168.50 | $17,288.59 | $19,564.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,144.88 / $16,856.31 / $22,765.72
| Facility | | $11,144.88 | $16,856.31 | $22,765.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,313.29 / $15,167.08 / $21,687.36
| Facility | | $10,313.29 | $15,167.08 | $21,687.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,878.81 / $16,823.00 / $20,811.00
| Facility | | $10,878.81 | $16,823.00 | $20,811.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,008.00 / $15,509.36 / $26,529.17
| Facility | | $4,008.00 | $15,509.36 | $26,529.17 |