- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,187.20 / $21,768.70 / $29,727.10
| Facility | | $12,187.20 | $21,768.70 | $29,727.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,177.00 / $23,314.77 / $32,275.00
| Facility | | $11,177.00 | $23,314.77 | $32,275.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,532.12 / $19,517.13 / $29,623.21
| Facility | | $11,532.12 | $19,517.13 | $29,623.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,940.46 / $21,940.46 / $26,641.98
| Facility | | $21,940.46 | $21,940.46 | $26,641.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,478.05 / $22,478.05 / $22,478.05
| Facility | | $22,478.05 | $22,478.05 | $22,478.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,007.50 / $21,563.00 / $29,727.10
| Facility | | $12,007.50 | $21,563.00 | $29,727.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,848.52 / $17,975.25 / $29,136.78
| Facility | | $10,848.52 | $17,975.25 | $29,136.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,965.74 / $15,361.32
| Facility | | $2,621.40 | $10,965.74 | $15,361.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,192.81 / $16,783.56 / $30,443.42
| Facility | | $6,192.81 | $16,783.56 | $30,443.42 |