- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,974.30 / $20,439.80 / $33,223.19
| Facility | | $11,974.30 | $20,439.80 | $33,223.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,177.00 / $15,905.61 / $21,733.17
| Facility | | $11,177.00 | $15,905.61 | $21,733.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,267.93 / $16,240.39 / $25,620.79
| Facility | | $10,267.93 | $16,240.39 | $25,620.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,765.50 / $15,609.19 / $28,850.80
| Facility | | $8,765.50 | $15,609.19 | $28,850.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,199.52 / $23,331.83
| Facility | | $6,289.00 | $17,199.52 | $23,331.83 |