- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,484.80 / $21,631.40 / $29,539.50
| Facility | | $12,484.80 | $21,631.40 | $29,539.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,207.00 / $21,482.00 / $31,937.00
| Facility | | $11,207.00 | $21,482.00 | $31,937.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,895.73 / $19,394.00 / $29,436.33
| Facility | | $10,895.73 | $19,394.00 | $29,436.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,802.04 / $21,802.04 / $26,473.91
| Facility | | $21,802.04 | $21,802.04 | $26,473.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,570.13 / $27,080.38 / $44,946.56
| Facility | | $13,570.13 | $27,080.38 | $44,946.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,931.70 / $21,169.60 / $29,232.60
| Facility | | $11,931.70 | $21,169.60 | $29,232.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,602.00 / $17,861.84 / $27,585.31
| Facility | | $10,602.00 | $17,861.84 | $27,585.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,344.50 / $14,491.06
| Facility | | $2,621.40 | $10,344.50 | $14,491.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,786.00 / $16,794.11 / $27,818.18
| Facility | | $3,786.00 | $16,794.11 | $27,818.18 |