- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,211.20 / $19,137.09 / $31,105.90
| Facility | | $11,211.20 | $19,137.09 | $31,105.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,180.84 / $12,229.83 / $21,173.24
| Facility | | $10,180.84 | $12,229.83 | $21,173.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,613.54 / $15,205.39 / $23,987.98
| Facility | | $9,613.54 | $15,205.39 | $23,987.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,612.66 / $10,853.12 / $24,192.73
| Facility | | $3,612.66 | $10,853.12 | $24,192.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $16,103.39 / $21,844.90
| Facility | | $6,289.00 | $16,103.39 | $21,844.90 |