- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,337.00 / $21,058.80 / $34,229.30
| Facility | | $12,337.00 | $21,058.80 | $34,229.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $17,671.91 / $23,355.73
| Facility | | $11,258.00 | $17,671.91 | $23,355.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,642.54 / $16,732.22 / $26,396.70
| Facility | | $10,642.54 | $16,732.22 | $26,396.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,863.45 / $15,755.65 / $28,880.26
| Facility | | $8,863.45 | $15,755.65 | $28,880.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $17,720.40 / $24,038.43
| Facility | | $6,289.00 | $17,720.40 | $24,038.43 |