- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $27,542.29
| Facility | | $12,022.64 | $17,782.79 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,471.29 / $15,135.61 / $23,988.33
| Facility | | $10,471.29 | $15,135.61 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,135.61 / $26,302.68
| Facility | | $9,549.93 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,848.93 / $23,442.29
| Facility | | $7,585.78 | $15,848.93 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $11,748.98 / $19,498.45
| Facility | | $7,413.10 | $11,748.98 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $19,054.61 / $26,915.35
| Facility | | $7,943.28 | $19,054.61 | $26,915.35 |