- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $19,498.45 / $30,199.52
| Facility | | $13,803.84 | $19,498.45 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $16,595.87 / $25,118.86
| Facility | | $11,220.18 | $16,595.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,595.87 / $28,840.32
| Facility | | $9,549.93 | $16,595.87 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,488.17 / $27,542.29
| Facility | | $7,585.78 | $15,488.17 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $12,882.50 / $21,379.62
| Facility | | $8,128.31 | $12,882.50 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $21,379.62 / $29,512.09
| Facility | | $8,709.64 | $21,379.62 | $29,512.09 |