- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $17,782.79 / $27,542.29
| Facility | | $10,964.78 | $17,782.79 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,489.63 / $21,877.62
| Facility | | $9,120.11 | $13,489.63 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,182.57 / $22,908.68
| Facility | | $8,912.51 | $13,182.57 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $14,125.38 / $21,877.62
| Facility | | $7,079.46 | $14,125.38 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,232.93 / $16,982.44
| Facility | | $6,456.54 | $10,232.93 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $17,378.01 / $33,884.42
| Facility | | $8,511.38 | $17,378.01 | $33,884.42 |