- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $21,877.62 / $31,622.78
| Facility | | $12,022.64 | $21,877.62 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,782.79 / $26,915.35 / $36,307.81
| Facility | | $17,782.79 | $26,915.35 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $19,952.62 / $29,512.09
| Facility | | $12,022.64 | $19,952.62 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,442.29 / $23,442.29 / $28,183.83
| Facility | | $23,442.29 | $23,442.29 | $28,183.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $22,387.21 / $27,542.29
| Facility | | $9,772.37 | $22,387.21 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $19,054.61 / $27,542.29
| Facility | | $11,481.54 | $19,054.61 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $20,417.38 / $30,902.95
| Facility | | $11,748.98 | $20,417.38 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $12,589.25 / $21,379.62
| Facility | | $9,332.54 | $12,589.25 | $21,379.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $15,848.93 / $27,542.29
| Facility | | $5,370.32 | $15,848.93 | $27,542.29 |