- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,589.25 / $16,218.10
| Facility | | $9,120.11 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $19,498.45
| Facility | | $8,511.38 | $8,511.38 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $11,220.18 / $15,488.17
| Facility | | $7,244.36 | $11,220.18 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $13,182.57 / $18,620.87
| Facility | | $6,918.31 | $13,182.57 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $12,302.69 / $15,488.17
| Facility | | $7,244.36 | $12,302.69 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $13,182.57 / $18,620.87
| Facility | | $6,918.31 | $13,182.57 | $18,620.87 |