- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,668.50 / $27,375.00 / $38,151.60
| Facility | | $15,668.50 | $27,375.00 | $38,151.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,196.00 / $30,595.30 / $44,154.00
| Facility | | $14,196.00 | $30,595.30 | $44,154.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,381.59 / $25,138.31 / $36,942.80
| Facility | | $14,381.59 | $25,138.31 | $36,942.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,361.72 / $27,361.72 / $33,224.94
| Facility | | $27,361.72 | $27,361.72 | $33,224.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,227.82 / $34,968.57 / $47,085.94
| Facility | | $10,227.82 | $34,968.57 | $47,085.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,974.40 / $27,147.50 / $37,810.00
| Facility | | $14,974.40 | $27,147.50 | $37,810.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,529.07 / $22,449.96 / $35,045.50
| Facility | | $13,529.07 | $22,449.96 | $35,045.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,020.70 / $18,476.71
| Facility | | $2,621.40 | $13,020.70 | $18,476.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,130.00 / $21,076.73 / $34,912.01
| Facility | | $5,130.00 | $21,076.73 | $34,912.01 |