- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,858.40 / $20,241.80 / $32,901.30
| Facility | | $11,858.40 | $20,241.80 | $32,901.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $17,421.93 / $21,262.39
| Facility | | $11,231.00 | $17,421.93 | $21,262.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,168.45 / $16,083.07 / $25,372.60
| Facility | | $10,168.45 | $16,083.07 | $25,372.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,279.48 / $14,734.05 / $27,313.06
| Facility | | $8,279.48 | $14,734.05 | $27,313.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $16,664.82 / $23,241.79
| Facility | | $6,164.00 | $16,664.82 | $23,241.79 |