- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,437.50 / $20,735.40 / $28,316.10
| Facility | | $11,437.50 | $20,735.40 | $28,316.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,054.45 / $16,054.45 / $16,054.45
| Facility | | $16,054.45 | $16,054.45 | $16,054.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,283.00 / $21,068.12 / $31,130.20
| Facility | | $10,283.00 | $21,068.12 | $31,130.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,984.75 / $19,200.79 / $28,217.14
| Facility | | $10,984.75 | $19,200.79 | $28,217.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,899.05 / $20,899.05 / $25,377.41
| Facility | | $20,899.05 | $20,899.05 | $25,377.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,149.90 / $20,593.59 / $33,463.81
| Facility | | $13,149.90 | $20,593.59 | $33,463.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,417.20 / $20,292.80 / $28,021.80
| Facility | | $11,417.20 | $20,292.80 | $28,021.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,444.45 / $17,147.41 / $27,077.26
| Facility | | $10,444.45 | $17,147.41 | $27,077.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,198.68 / $14,281.00
| Facility | | $2,621.40 | $10,198.68 | $14,281.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,898.86 / $15,986.92 / $28,998.41
| Facility | | $5,898.86 | $15,986.92 | $28,998.41 |