- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,753.20 / $25,561.70 / $34,906.69
| Facility | | $14,753.20 | $25,561.70 | $34,906.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,762.01 / $33,762.01 / $33,762.01
| Facility | | $33,762.01 | $33,762.01 | $33,762.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,177.00 / $25,658.00 / $37,535.85
| Facility | | $12,177.00 | $25,658.00 | $37,535.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,683.75 / $23,669.83 / $34,282.40
| Facility | | $13,683.75 | $23,669.83 | $34,282.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,763.35 / $25,763.35 / $31,284.07
| Facility | | $25,763.35 | $25,763.35 | $31,284.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,732.70 / $30,991.75 / $42,390.49
| Facility | | $17,732.70 | $30,991.75 | $42,390.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,099.60 / $25,016.00 / $34,544.00
| Facility | | $14,099.60 | $25,016.00 | $34,544.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,875.42 / $21,138.52 / $34,282.40
| Facility | | $12,875.42 | $21,138.52 | $34,282.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $12,750.08 / $18,074.37
| Facility | | $2,621.40 | $12,750.08 | $18,074.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,271.84 / $19,707.91 / $35,747.86
| Facility | | $7,271.84 | $19,707.91 | $35,747.86 |