- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,838.80 / $18,501.40 / $30,072.60
| Facility | | $10,838.80 | $18,501.40 | $30,072.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,258.00 / $17,891.24 / $20,569.73
| Facility | | $11,258.00 | $17,891.24 | $20,569.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,294.21 / $14,700.31 / $23,191.16
| Facility | | $9,294.21 | $14,700.31 | $23,191.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,437.77 / $14,578.14 / $27,331.58
| Facility | | $8,437.77 | $14,578.14 | $27,331.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,289.00 / $15,568.48 / $21,119.27
| Facility | | $6,289.00 | $15,568.48 | $21,119.27 |