- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $20,417.38 / $29,512.09
| Facility | | $13,489.63 | $20,417.38 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,848.93 / $24,547.09
| Facility | | $10,964.78 | $15,848.93 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,848.93 / $28,183.83
| Facility | | $9,549.93 | $15,848.93 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,135.61 / $25,118.86
| Facility | | $7,585.78 | $15,135.61 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,302.69 / $20,892.96
| Facility | | $7,762.47 | $12,302.69 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $19,952.62 / $28,840.32
| Facility | | $7,413.10 | $19,952.62 | $28,840.32 |