- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,691.10 / $27,186.80 / $40,117.50
| Facility | | $15,691.10 | $27,186.80 | $40,117.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,207.00 / $28,350.76 / $39,602.73
| Facility | | $14,207.00 | $28,350.76 | $39,602.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,693.98 / $25,174.64 / $36,996.19
| Facility | | $13,693.98 | $25,174.64 | $36,996.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,401.27 / $27,401.27 / $33,272.97
| Facility | | $27,401.27 | $27,401.27 | $33,272.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,549.48 / $33,136.54 / $44,258.99
| Facility | | $14,549.48 | $33,136.54 | $44,258.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,996.00 / $27,186.80 / $38,206.80
| Facility | | $14,996.00 | $27,186.80 | $38,206.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,238.00 / $22,482.41 / $34,669.80
| Facility | | $13,238.00 | $22,482.41 | $34,669.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,519.84 / $17,732.04
| Facility | | $2,621.40 | $12,519.84 | $17,732.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,734.15 / $20,960.84 / $38,020.55
| Facility | | $7,734.15 | $20,960.84 | $38,020.55 |