- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,566.90 / $29,591.70 / $40,410.10
| Facility | | $16,566.90 | $29,591.70 | $40,410.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,894.00 / $26,754.00 / $46,695.10
| Facility | | $14,894.00 | $26,754.00 | $46,695.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,905.35 / $26,530.98 / $40,268.87
| Facility | | $14,905.35 | $26,530.98 | $40,268.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,825.18 / $29,825.18 / $36,216.29
| Facility | | $29,825.18 | $29,825.18 | $36,216.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,063.00 / $35,361.73 / $56,743.92
| Facility | | $15,063.00 | $35,361.73 | $56,743.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,322.60 / $27,685.80 / $39,990.10
| Facility | | $16,322.60 | $27,685.80 | $39,990.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,825.21 / $24,435.00 / $40,068.08
| Facility | | $13,825.21 | $24,435.00 | $40,068.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $15,453.23 / $22,093.36
| Facility | | $2,621.40 | $15,453.23 | $22,093.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,271.70 / $22,815.05 / $41,383.83
| Facility | | $8,271.70 | $22,815.05 | $41,383.83 |