- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $25,703.96 / $38,904.51
| Facility | | $14,454.40 | $25,703.96 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $36,307.81 / $50,118.72
| Facility | | $20,892.96 | $36,307.81 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $23,988.33 / $33,884.42
| Facility | | $14,125.38 | $23,988.33 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,542.29 / $27,542.29 / $33,113.11
| Facility | | $27,542.29 | $27,542.29 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $26,302.68 / $33,113.11
| Facility | | $13,803.84 | $26,302.68 | $33,113.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $25,703.96 / $40,738.03
| Facility | | $12,882.50 | $25,703.96 | $40,738.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $24,547.09 / $37,153.52
| Facility | | $14,125.38 | $24,547.09 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $13,182.57 / $21,877.62
| Facility | | $11,481.54 | $13,182.57 | $21,877.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $18,620.87 / $33,113.11
| Facility | | $5,370.32 | $18,620.87 | $33,113.11 |