- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $22,387.21 / $31,622.78
| Facility | | $12,589.25 | $22,387.21 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $21,877.62 / $37,153.52
| Facility | | $12,022.64 | $21,877.62 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,220.18 / $20,892.96 / $33,113.11
| Facility | | $11,220.18 | $20,892.96 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,988.33 / $23,988.33 / $28,840.32
| Facility | | $23,988.33 | $23,988.33 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $22,908.68 / $28,183.83
| Facility | | $10,000.00 | $22,908.68 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,498.45 / $19,498.45 / $38,018.94
| Facility | | $19,498.45 | $19,498.45 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,302.69 / $20,892.96 / $30,199.52
| Facility | | $12,302.69 | $20,892.96 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $9,772.37 / $13,489.63
| Facility | | $8,128.31 | $9,772.37 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $16,218.10 / $28,183.83
| Facility | | $5,370.32 | $16,218.10 | $28,183.83 |