- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,488.17 / $23,988.33
| Facility | | $10,964.78 | $15,488.17 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $13,182.57 / $20,417.38
| Facility | | $9,120.11 | $13,182.57 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,182.57 / $22,908.68
| Facility | | $8,912.51 | $13,182.57 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $12,589.25 / $21,877.62
| Facility | | $7,079.46 | $12,589.25 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $10,232.93 / $17,378.01
| Facility | | $6,456.54 | $10,232.93 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $16,595.87 / $23,442.29
| Facility | | $7,413.10 | $16,595.87 | $23,442.29 |