- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,642.20 / $21,579.80 / $35,076.19
| Facility | | $12,642.20 | $21,579.80 | $35,076.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,547.73 / $17,394.72 / $22,368.93
| Facility | | $11,547.73 | $17,394.72 | $22,368.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,905.87 / $17,146.22 / $27,049.83
| Facility | | $10,905.87 | $17,146.22 | $27,049.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,532.09 / $20,001.30 / $38,736.69
| Facility | | $10,532.09 | $20,001.30 | $38,736.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,970.65 / $19,890.03 / $26,515.00
| Facility | | $13,970.65 | $19,890.03 | $26,515.00 |