- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,477.40 / $18,714.70 / $25,556.60
| Facility | | $10,477.40 | $18,714.70 | $25,556.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,972.49 / $14,972.49 / $14,972.49
| Facility | | $14,972.49 | $14,972.49 | $14,972.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,459.92 / $8,459.92 / $8,639.91
| Facility | | $8,459.92 | $8,459.92 | $8,639.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,018.41 / $17,513.91 / $25,467.29
| Facility | | $10,018.41 | $17,513.91 | $25,467.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,862.37 / $18,862.37 / $22,904.30
| Facility | | $18,862.37 | $18,862.37 | $22,904.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,945.11 / $19,806.81 / $29,338.14
| Facility | | $13,945.11 | $19,806.81 | $29,338.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,322.90 / $18,714.70 / $25,291.00
| Facility | | $10,322.90 | $18,714.70 | $25,291.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,426.60 / $16,746.96 / $23,865.85
| Facility | | $9,426.60 | $16,746.96 | $23,865.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $15,761.37 / $26,172.42
| Facility | | $5,404.00 | $15,761.37 | $26,172.42 |