- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,292.30 / $21,297.80 / $29,084.10
| Facility | | $12,292.30 | $21,297.80 | $29,084.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,464.00 / $21,588.84 / $31,235.00
| Facility | | $10,464.00 | $21,588.84 | $31,235.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,401.23 / $19,094.98 / $28,982.47
| Facility | | $11,401.23 | $19,094.98 | $28,982.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,465.89 / $21,465.89 / $26,065.72
| Facility | | $21,465.89 | $21,465.89 | $26,065.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,416.26 / $22,044.15 / $27,240.32
| Facility | | $7,416.26 | $22,044.15 | $27,240.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,747.70 / $21,244.00 / $28,781.90
| Facility | | $11,747.70 | $21,244.00 | $28,781.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,727.73 / $17,586.45 / $27,648.53
| Facility | | $10,727.73 | $17,586.45 | $27,648.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,406.37 / $14,577.75
| Facility | | $2,621.40 | $10,406.37 | $14,577.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,058.86 / $16,420.53 / $29,784.93
| Facility | | $6,058.86 | $16,420.53 | $29,784.93 |