- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,577.30 / $21,164.70 / $31,964.10
| Facility | | $11,577.30 | $21,164.70 | $31,964.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,069.25 / $13,069.25 / $17,007.43
| Facility | | $13,069.25 | $13,069.25 | $17,007.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,326.00 / $25,985.64 / $36,407.69
| Facility | | $11,326.00 | $25,985.64 | $36,407.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,235.82 / $19,435.45 / $28,561.98
| Facility | | $11,235.82 | $19,435.45 | $28,561.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,154.46 / $21,154.46 / $25,687.55
| Facility | | $21,154.46 | $21,154.46 | $25,687.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,408.89 / $18,346.86 / $29,040.34
| Facility | | $8,408.89 | $18,346.86 | $29,040.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,556.80 / $20,988.80 / $31,263.00
| Facility | | $11,556.80 | $20,988.80 | $31,263.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,572.09 / $17,356.98 / $27,505.18
| Facility | | $10,572.09 | $17,356.98 | $27,505.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,353.23 / $14,503.28
| Facility | | $2,621.40 | $10,353.23 | $14,503.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,970.95 / $16,182.30 / $29,352.80
| Facility | | $5,970.95 | $16,182.30 | $29,352.80 |