- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $30,199.52 / $42,657.95
| Facility | | $16,595.87 | $30,199.52 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $19,054.61 / $19,054.61
| Facility | | $19,054.61 | $19,054.61 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $33,113.11 / $48,977.88
| Facility | | $20,892.96 | $33,113.11 | $48,977.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,848.93 / $27,542.29 / $38,904.51
| Facility | | $15,848.93 | $27,542.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $38,904.51
| Facility | | $32,359.37 | $32,359.37 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $30,199.52 / $38,018.94
| Facility | | $13,489.63 | $30,199.52 | $38,018.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,892.96 / $30,199.52 / $42,657.95
| Facility | | $20,892.96 | $30,199.52 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,595.87 / $28,183.83 / $41,686.94
| Facility | | $16,595.87 | $28,183.83 | $41,686.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $16,982.44 / $27,542.29
| Facility | | $12,882.50 | $16,982.44 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $21,877.62 / $38,018.94
| Facility | | $5,370.32 | $21,877.62 | $38,018.94 |