- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,638.00 / $20,787.80 / $28,387.50
| Facility | | $11,638.00 | $20,787.80 | $28,387.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,527.00 / $22,683.35 / $32,089.00
| Facility | | $10,527.00 | $22,683.35 | $32,089.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,012.46 / $18,637.65 / $28,288.33
| Facility | | $11,012.46 | $18,637.65 | $28,288.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,951.78 / $20,951.78 / $25,441.44
| Facility | | $20,951.78 | $20,951.78 | $25,441.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,923.44 / $5,923.44 / $31,578.09
| Facility | | $5,923.44 | $5,923.44 | $31,578.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,466.40 / $20,787.80 / $28,387.50
| Facility | | $11,466.40 | $20,787.80 | $28,387.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,359.66 / $17,165.25 / $26,509.50
| Facility | | $10,359.66 | $17,165.25 | $26,509.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,898.17 / $13,834.19
| Facility | | $2,621.40 | $9,898.17 | $13,834.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,913.75 / $16,027.26 / $29,071.58
| Facility | | $5,913.75 | $16,027.26 | $29,071.58 |