- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,212.40 / $20,846.20 / $33,883.80
| Facility | | $12,212.40 | $20,846.20 | $33,883.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,339.00 / $18,659.59 / $22,801.05
| Facility | | $11,339.00 | $18,659.59 | $22,801.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,535.11 / $16,563.31 / $26,130.23
| Facility | | $10,535.11 | $16,563.31 | $26,130.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,562.91 / $17,290.91 / $31,855.37
| Facility | | $9,562.91 | $17,290.91 | $31,855.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,541.50 / $23,795.76
| Facility | | $6,289.00 | $17,541.50 | $23,795.76 |