- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,952.62 / $22,387.21
| Facility | | $14,454.40 | $19,952.62 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $12,882.50 / $17,782.79
| Facility | | $11,481.54 | $12,882.50 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $18,620.87 / $24,547.09
| Facility | | $10,715.19 | $18,620.87 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,454.40 / $35,481.34
| Facility | | $9,332.54 | $14,454.40 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $14,125.38 / $20,892.96
| Facility | | $9,332.54 | $14,125.38 | $20,892.96 |