- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,761.90 / $20,077.09 / $32,633.70
| Facility | | $11,761.90 | $20,077.09 | $32,633.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $16,166.64 / $23,608.07
| Facility | | $11,231.00 | $16,166.64 | $23,608.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,085.75 / $16,271.10 / $25,166.21
| Facility | | $10,085.75 | $16,271.10 | $25,166.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,299.70 / $17,350.45 / $32,780.26
| Facility | | $9,299.70 | $17,350.45 | $32,780.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $16,894.36 / $22,917.87
| Facility | | $6,289.00 | $16,894.36 | $22,917.87 |