- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,300.00 / $29,798.40 / $45,003.10
| Facility | | $16,300.00 | $29,798.40 | $45,003.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,770.00 / $36,372.28 / $53,751.00
| Facility | | $17,770.00 | $36,372.28 | $53,751.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,819.24 / $28,197.00 / $42,383.00
| Facility | | $15,819.24 | $28,197.00 | $42,383.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,783.99 / $29,783.99 / $36,166.26
| Facility | | $29,783.99 | $29,783.99 | $36,166.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,842.50 / $36,305.71 / $57,744.35
| Facility | | $29,842.50 | $36,305.71 | $57,744.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,271.10 / $29,550.80 / $45,779.00
| Facility | | $16,271.10 | $29,550.80 | $45,779.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,884.76 / $26,494.34 / $38,102.10
| Facility | | $14,884.76 | $26,494.34 | $38,102.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $14,084.46 / $20,058.30
| Facility | | $2,621.40 | $14,084.46 | $20,058.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,406.68 / $26,020.77 / $42,315.38
| Facility | | $8,406.68 | $26,020.77 | $42,315.38 |