- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,857.30 / $19,393.20 / $27,254.10
| Facility | | $10,857.30 | $19,393.20 | $27,254.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,411.00 / $21,310.13 / $31,425.48
| Facility | | $10,411.00 | $21,310.13 | $31,425.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,273.68 / $18,184.45 / $26,390.58
| Facility | | $10,273.68 | $18,184.45 | $26,390.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,546.20 / $19,546.20 / $23,734.68
| Facility | | $19,546.20 | $19,546.20 | $23,734.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,035.55 / $24,999.58 / $34,102.33
| Facility | | $18,035.55 | $24,999.58 | $34,102.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,697.20 / $19,393.20 / $26,483.10
| Facility | | $10,697.20 | $19,393.20 | $26,483.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,664.67 / $16,037.42 / $26,250.92
| Facility | | $9,664.67 | $16,037.42 | $26,250.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,901.91 / $13,839.75
| Facility | | $2,621.40 | $9,901.91 | $13,839.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,517.02 / $14,952.05 / $27,121.28
| Facility | | $5,517.02 | $14,952.05 | $27,121.28 |