- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,182.57 / $18,620.87 / $28,840.32
| Facility | | $13,182.57 | $18,620.87 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $15,848.93 / $24,547.09
| Facility | | $10,964.78 | $15,848.93 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $15,848.93 / $27,542.29
| Facility | | $9,549.93 | $15,848.93 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $15,135.61 / $26,302.68
| Facility | | $7,585.78 | $15,135.61 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $12,302.69 / $20,892.96
| Facility | | $7,762.47 | $12,302.69 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,709.64 / $20,892.96 / $28,183.83
| Facility | | $8,709.64 | $20,892.96 | $28,183.83 |