- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,916.50 / $33,788.50 / $46,920.00
| Facility | | $18,916.50 | $33,788.50 | $46,920.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,995.00 / $36,195.86 / $50,536.00
| Facility | | $16,995.00 | $36,195.86 | $50,536.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,087.75 / $30,293.69 / $45,564.00
| Facility | | $18,087.75 | $30,293.69 | $45,564.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34,055.08 / $34,055.08 / $41,352.60
| Facility | | $34,055.08 | $34,055.08 | $41,352.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,668.51 / $39,667.35 / $49,633.26
| Facility | | $25,668.51 | $39,667.35 | $49,633.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,637.50 / $33,788.50 / $46,141.10
| Facility | | $18,637.50 | $33,788.50 | $46,141.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,019.27 / $27,900.45 / $43,088.63
| Facility | | $17,019.27 | $27,900.45 | $43,088.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $15,379.97 / $21,984.44
| Facility | | $2,621.40 | $15,379.97 | $21,984.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,612.21 / $26,050.75 / $47,253.03
| Facility | | $9,612.21 | $26,050.75 | $47,253.03 |