- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,091.33 / $15,081.00 / $20,237.50
| Facility | | $9,091.33 | $15,081.00 | $20,237.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,113.77 / $11,185.59 / $23,851.87
| Facility | | $8,113.77 | $11,185.59 | $23,851.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,184.61 / $12,531.79 / $19,937.38
| Facility | | $7,184.61 | $12,531.79 | $19,937.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,465.21 / $12,142.50 / $27,847.61
| Facility | | $7,465.21 | $12,142.50 | $27,847.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,810.60 / $11,961.17 / $16,944.45
| Facility | | $8,810.60 | $11,961.17 | $16,944.45 |