- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,478.30 / $22,288.60 / $31,172.00
| Facility | | $12,478.30 | $22,288.60 | $31,172.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,727.00 / $24,794.60 / $33,576.00
| Facility | | $11,727.00 | $24,794.60 | $33,576.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,931.60 / $20,899.39 / $30,330.70
| Facility | | $11,931.60 | $20,899.39 | $30,330.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,464.46 / $22,464.46 / $27,278.27
| Facility | | $22,464.46 | $22,464.46 | $27,278.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,587.39 / $26,994.11 / $49,633.26
| Facility | | $16,587.39 | $26,994.11 | $49,633.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,294.20 / $22,288.60 / $30,437.00
| Facility | | $12,294.20 | $22,288.60 | $30,437.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,226.78 / $18,431.82 / $28,883.82
| Facility | | $11,226.78 | $18,431.82 | $28,883.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,871.32 / $15,229.06
| Facility | | $2,621.40 | $10,871.32 | $15,229.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,340.71 / $17,184.40 / $31,170.49
| Facility | | $6,340.71 | $17,184.40 | $31,170.49 |