- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,293.00 / $17,569.80 / $28,558.30
| Facility | | $10,293.00 | $17,569.80 | $28,558.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $11,339.00 / $21,428.94
| Facility | | $9,687.00 | $11,339.00 | $21,428.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,879.32 / $13,960.08 / $22,023.38
| Facility | | $8,879.32 | $13,960.08 | $22,023.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,302.70 / $15,433.77 / $28,312.30
| Facility | | $8,302.70 | $15,433.77 | $28,312.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $14,784.53 / $20,055.81
| Facility | | $6,289.00 | $14,784.53 | $20,055.81 |