- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,020.20 / $19,684.20 / $28,030.00
| Facility | | $11,020.20 | $19,684.20 | $28,030.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,133.00 / $22,749.78 / $30,189.00
| Facility | | $10,133.00 | $22,749.78 | $30,189.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,537.41 / $18,227.36 / $27,083.98
| Facility | | $10,537.41 | $18,227.36 | $27,083.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,839.50 / $19,839.50 / $24,090.84
| Facility | | $19,839.50 | $19,839.50 | $24,090.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,608.03 / $19,143.36 / $27,481.20
| Facility | | $10,608.03 | $19,143.36 | $27,481.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,838.40 / $19,684.20 / $26,880.50
| Facility | | $10,838.40 | $19,684.20 | $26,880.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,914.94 / $17,364.00 / $25,420.37
| Facility | | $9,914.94 | $17,364.00 | $25,420.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,608.87 / $13,404.06
| Facility | | $2,621.40 | $9,608.87 | $13,404.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,599.80 / $15,056.02 / $27,528.26
| Facility | | $5,599.80 | $15,056.02 | $27,528.26 |