- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $17,782.79 / $25,118.86
| Facility | | $9,772.37 | $17,782.79 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,387.21 / $22,387.21 / $22,387.21
| Facility | | $22,387.21 | $22,387.21 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,748.98 / $19,498.45 / $28,840.32
| Facility | | $11,748.98 | $19,498.45 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,772.37 / $16,218.10 / $26,302.68
| Facility | | $9,772.37 | $16,218.10 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $22,908.68
| Facility | | $18,620.87 | $18,620.87 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $17,378.01 / $22,387.21
| Facility | | $7,943.28 | $17,378.01 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,760.83 / $16,982.44 / $22,387.21
| Facility | | $6,760.83 | $16,982.44 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $16,218.10 / $23,988.33
| Facility | | $9,549.93 | $16,218.10 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $9,332.54 / $15,488.17
| Facility | | $7,585.78 | $9,332.54 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $12,882.50 / $22,387.21
| Facility | | $4,466.84 | $12,882.50 | $22,387.21 |