- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,135.50 / $17,300.90 / $28,121.30
| Facility | | $10,135.50 | $17,300.90 | $28,121.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,687.00 / $16,162.82 / $19,520.83
| Facility | | $9,687.00 | $16,162.82 | $19,520.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,691.15 / $13,746.46 / $21,686.36
| Facility | | $8,691.15 | $13,746.46 | $21,686.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,623.36 / $11,918.08 / $21,978.56
| Facility | | $6,623.36 | $11,918.08 | $21,978.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $14,558.29 / $19,748.91
| Facility | | $6,289.00 | $14,558.29 | $19,748.91 |