- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,791.08 / $20,417.38 / $32,359.37
| Facility | | $14,791.08 | $20,417.38 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $17,782.79 / $26,915.35
| Facility | | $12,022.64 | $17,782.79 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $17,782.79 / $30,902.95
| Facility | | $9,549.93 | $17,782.79 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $18,197.01 / $30,199.52
| Facility | | $7,585.78 | $18,197.01 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $13,803.84 / $22,908.68
| Facility | | $8,709.64 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $22,387.21 / $31,622.78
| Facility | | $8,709.64 | $22,387.21 | $31,622.78 |