- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,790.90 / $19,563.20 / $26,715.30
| Facility | | $10,790.90 | $19,563.20 | $26,715.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,002.00 / $19,064.07 / $28,805.00
| Facility | | $9,002.00 | $19,064.07 | $28,805.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,363.75 / $17,539.75 / $26,621.96
| Facility | | $10,363.75 | $17,539.75 | $26,621.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,717.57 / $19,717.57 / $23,942.77
| Facility | | $19,717.57 | $19,717.57 | $23,942.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,486.66 / $16,472.09 / $31,848.54
| Facility | | $7,486.66 | $16,472.09 | $31,848.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,771.80 / $19,145.59 / $26,437.70
| Facility | | $10,771.80 | $19,145.59 | $26,437.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,749.41 / $16,154.10 / $24,947.91
| Facility | | $9,749.41 | $16,154.10 | $24,947.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,288.91 / $12,928.36
| Facility | | $2,621.40 | $9,288.91 | $12,928.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,509.88 / $15,083.14 / $27,359.06
| Facility | | $5,509.88 | $15,083.14 | $27,359.06 |