- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,701.10 / $26,652.10 / $37,444.00
| Facility | | $14,701.10 | $26,652.10 | $37,444.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,791.00 / $30,278.30 / $42,447.00
| Facility | | $13,791.00 | $30,278.30 | $42,447.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,267.51 / $24,679.60 / $35,261.23
| Facility | | $14,267.51 | $24,679.60 | $35,261.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,862.44 / $26,862.44 / $32,618.67
| Facility | | $26,862.44 | $26,862.44 | $32,618.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,663.25 / $30,834.46 / $53,233.56
| Facility | | $17,663.25 | $30,834.46 | $53,233.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,675.10 / $26,652.10 / $36,395.80
| Facility | | $14,675.10 | $26,652.10 | $36,395.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,424.70 / $22,040.30 / $35,070.80
| Facility | | $13,424.70 | $22,040.30 | $35,070.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,031.16 / $18,492.27
| Facility | | $2,621.40 | $13,031.16 | $18,492.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,582.06 / $20,548.66 / $37,272.89
| Facility | | $7,582.06 | $20,548.66 | $37,272.89 |