- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,920.60 / $20,348.00 / $33,074.10
| Facility | | $11,920.60 | $20,348.00 | $33,074.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $17,499.28 / $23,066.31
| Facility | | $11,231.00 | $17,499.28 | $23,066.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,221.86 / $16,167.53 / $25,505.84
| Facility | | $10,221.86 | $16,167.53 | $25,505.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,128.41 / $16,407.31 / $30,587.48
| Facility | | $9,128.41 | $16,407.31 | $30,587.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,122.34 / $23,227.15
| Facility | | $6,289.00 | $17,122.34 | $23,227.15 |