- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,138.20 / $26,228.70 / $35,817.60
| Facility | | $15,138.20 | $26,228.70 | $35,817.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,177.46 / $16,177.46 / $16,177.46
| Facility | | $16,177.46 | $16,177.46 | $16,177.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,880.00 / $24,842.10 / $36,920.90
| Facility | | $11,880.00 | $24,842.10 | $36,920.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,211.41 / $23,515.83 / $33,818.64
| Facility | | $13,211.41 | $23,515.83 | $33,818.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,435.66 / $26,435.66 / $32,100.44
| Facility | | $26,435.66 | $26,435.66 | $32,100.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,555.92 / $31,323.06 / $60,881.76
| Facility | | $26,555.92 | $31,323.06 | $60,881.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,467.60 / $25,668.80 / $35,445.40
| Facility | | $14,467.60 | $25,668.80 | $35,445.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,031.00 / $21,658.05 / $33,448.05
| Facility | | $13,031.00 | $21,658.05 | $33,448.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,146.81 / $17,177.43
| Facility | | $2,621.40 | $12,146.81 | $17,177.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,461.60 / $20,061.77 / $36,680.72
| Facility | | $7,461.60 | $20,061.77 | $36,680.72 |