- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,061.20 / $29,560.60 / $40,367.60
| Facility | | $17,061.20 | $29,560.60 | $40,367.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,379.00 / $26,225.00 / $42,294.10
| Facility | | $14,379.00 | $26,225.00 | $42,294.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,889.70 / $26,503.13 / $40,226.61
| Facility | | $14,889.70 | $26,503.13 | $40,226.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,793.87 / $29,793.87 / $36,178.26
| Facility | | $29,793.87 | $29,793.87 | $36,178.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,305.40 / $28,929.60 / $39,948.19
| Facility | | $16,305.40 | $28,929.60 | $39,948.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,810.70 / $24,409.35 / $37,697.08
| Facility | | $13,810.70 | $24,409.35 | $37,697.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,066.30 / $18,544.50
| Facility | | $2,621.40 | $13,066.30 | $18,544.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,263.02 / $22,791.10 / $41,340.40
| Facility | | $8,263.02 | $22,791.10 | $41,340.40 |