- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,884.03 / $16,273.40 / $23,041.40
| Facility | | $8,884.03 | $16,273.40 | $23,041.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,544.88 / $17,209.25 / $28,102.04
| Facility | | $10,544.88 | $17,209.25 | $28,102.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,236.70 / $14,638.77 / $26,044.70
| Facility | | $9,236.70 | $14,638.77 | $26,044.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,877.90 / $14,200.73 / $30,797.90
| Facility | | $5,877.90 | $14,200.73 | $30,797.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,308.00 / $13,510.77 / $27,368.62
| Facility | | $3,308.00 | $13,510.77 | $27,368.62 |