- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,953.60 / $20,404.30 / $33,165.60
| Facility | | $11,953.60 | $20,404.30 | $33,165.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,231.00 / $19,317.77 / $24,294.40
| Facility | | $11,231.00 | $19,317.77 | $24,294.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,250.12 / $16,212.24 / $25,576.38
| Facility | | $10,250.12 | $16,212.24 | $25,576.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.01 / $15,547.50 / $29,512.34
| Facility | | $8,158.01 | $15,547.50 | $29,512.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,169.70 / $23,291.39
| Facility | | $6,289.00 | $17,169.70 | $23,291.39 |