- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,393.10 / $21,154.60 / $34,385.19
| Facility | | $12,393.10 | $21,154.60 | $34,385.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $18,727.50 / $22,512.26
| Facility | | $11,231.00 | $18,727.50 | $22,512.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,691.00 / $16,808.40 / $26,516.88
| Facility | | $10,691.00 | $16,808.40 | $26,516.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,605.17 / $16,201.53 / $29,393.00
| Facility | | $8,605.17 | $16,201.53 | $29,393.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,164.00 / $17,416.39 / $24,289.97
| Facility | | $6,164.00 | $17,416.39 | $24,289.97 |