- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,979.40 / $21,471.00 / $30,409.00
| Facility | | $11,979.40 | $21,471.00 | $30,409.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,787.00 / $24,511.52 / $34,471.00
| Facility | | $11,787.00 | $24,511.52 | $34,471.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,454.62 / $20,417.28 / $29,118.18
| Facility | | $11,454.62 | $20,417.28 | $29,118.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,566.41 / $21,566.41 / $26,187.78
| Facility | | $21,566.41 | $21,566.41 | $26,187.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,027.09 / $26,386.83 / $45,728.99
| Facility | | $17,027.09 | $26,386.83 | $45,728.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,802.80 / $21,397.60 / $30,071.00
| Facility | | $11,802.80 | $21,397.60 | $30,071.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,777.97 / $19,147.74 / $27,287.17
| Facility | | $10,777.97 | $19,147.74 | $27,287.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,003.57 / $13,990.91
| Facility | | $2,621.40 | $10,003.57 | $13,990.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,087.23 / $16,497.41 / $29,924.40
| Facility | | $6,087.23 | $16,497.41 | $29,924.40 |