- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,809.60 / $22,880.40 / $31,245.20
| Facility | | $12,809.60 | $22,880.40 | $31,245.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,691.00 / $25,303.68 / $34,431.85
| Facility | | $12,691.00 | $25,303.68 | $34,431.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,121.07 / $21,454.34 / $31,136.08
| Facility | | $12,121.07 | $21,454.34 | $31,136.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,060.96 / $23,060.96 / $28,002.60
| Facility | | $23,060.96 | $23,060.96 | $28,002.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,428.89 / $30,517.62 / $46,956.80
| Facility | | $9,428.89 | $30,517.62 | $46,956.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,620.70 / $22,392.00 / $31,245.20
| Facility | | $12,620.70 | $22,392.00 | $31,245.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,402.55 / $18,921.24 / $30,974.95
| Facility | | $11,402.55 | $18,921.24 | $30,974.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,599.32 / $16,330.51
| Facility | | $2,621.40 | $11,599.32 | $16,330.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,509.07 / $17,640.70 / $31,998.17
| Facility | | $6,509.07 | $17,640.70 | $31,998.17 |