- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,654.23 / $15,852.50 / $22,445.40
| Facility | | $8,654.23 | $15,852.50 | $22,445.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,893.23 / $15,958.51 / $25,429.31
| Facility | | $9,893.23 | $15,958.51 | $25,429.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,997.78 / $14,260.12 / $25,371.01
| Facility | | $8,997.78 | $14,260.12 | $25,371.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,725.86 / $13,454.41 / $30,001.27
| Facility | | $5,725.86 | $13,454.41 | $30,001.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,161.30 / $26,660.69
| Facility | | $3,308.00 | $13,161.30 | $26,660.69 |