- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,449.30 / $21,250.50 / $34,541.00
| Facility | | $12,449.30 | $21,250.50 | $34,541.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $20,561.47 / $22,370.02
| Facility | | $11,258.00 | $20,561.47 | $22,370.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,636.00 / $16,884.58 / $26,637.05
| Facility | | $10,636.00 | $16,884.58 | $26,637.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,927.62 / $16,040.35 / $29,593.99
| Facility | | $8,927.62 | $16,040.35 | $29,593.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,881.74 / $24,257.30
| Facility | | $6,289.00 | $17,881.74 | $24,257.30 |