- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $16,982.44 / $26,915.35
| Facility | | $12,302.69 | $16,982.44 | $26,915.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $14,454.40 / $22,387.21
| Facility | | $10,000.00 | $14,454.40 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $14,791.08 / $25,703.96
| Facility | | $9,549.93 | $14,791.08 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $13,803.84 / $23,988.33
| Facility | | $7,244.36 | $13,803.84 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $11,220.18 / $19,054.61
| Facility | | $7,079.46 | $11,220.18 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $18,197.01 / $25,703.96
| Facility | | $7,943.28 | $18,197.01 | $25,703.96 |