- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,769.60 / $24,963.30 / $35,677.50
| Facility | | $13,769.60 | $24,963.30 | $35,677.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,084.00 / $26,019.83 / $35,957.01
| Facility | | $11,084.00 | $26,019.83 | $35,957.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,363.43 / $22,381.30 / $32,187.05
| Facility | | $13,363.43 | $22,381.30 | $32,187.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,160.26 / $25,160.26 / $30,551.74
| Facility | | $25,160.26 | $25,160.26 | $30,551.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,386.45 / $22,228.49 / $32,224.43
| Facility | | $11,386.45 | $22,228.49 | $32,224.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,745.20 / $24,963.30 / $34,089.60
| Facility | | $13,745.20 | $24,963.30 | $34,089.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,574.02 / $20,613.15 / $31,834.34
| Facility | | $12,574.02 | $20,613.15 | $31,834.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,809.26 / $16,661.72
| Facility | | $2,621.40 | $11,809.26 | $16,661.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,101.61 / $19,246.57 / $34,911.04
| Facility | | $7,101.61 | $19,246.57 | $34,911.04 |