- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,908.20 / $19,775.80 / $27,341.00
| Facility | | $10,908.20 | $19,775.80 | $27,341.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,160.00 / $22,431.16 / $30,993.00
| Facility | | $10,160.00 | $22,431.16 | $30,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,476.35 / $17,730.32 / $26,911.18
| Facility | | $10,476.35 | $17,730.32 | $26,911.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,931.79 / $19,931.79 / $24,202.89
| Facility | | $19,931.79 | $19,931.79 | $24,202.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,145.13 / $20,019.78 / $28,032.35
| Facility | | $8,145.13 | $20,019.78 | $28,032.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,888.80 / $19,775.80 / $27,005.50
| Facility | | $10,888.80 | $19,775.80 | $27,005.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,855.32 / $16,329.60 / $25,901.00
| Facility | | $9,855.32 | $16,329.60 | $25,901.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,778.56 / $13,656.36
| Facility | | $2,621.40 | $9,778.56 | $13,656.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,625.85 / $15,247.01 / $27,656.29
| Facility | | $5,625.85 | $15,247.01 | $27,656.29 |