- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,935.14 / $15,379.40 / $17,404.20
| Facility | | $9,935.14 | $15,379.40 | $17,404.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,009.10 / $15,138.48 / $20,445.66
| Facility | | $10,009.10 | $15,138.48 | $20,445.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,174.37 / $13,492.15 / $19,292.38
| Facility | | $9,174.37 | $13,492.15 | $19,292.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,645.00 / $15,237.00 / $19,893.00
| Facility | | $9,645.00 | $15,237.00 | $19,893.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,274.00 / $17,774.41 / $23,656.32
| Facility | | $5,274.00 | $17,774.41 | $23,656.32 |