- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,190.70 / $28,919.70 / $39,492.50
| Facility | | $16,190.70 | $28,919.70 | $39,492.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,784.00 / $33,181.87 / $48,123.00
| Facility | | $17,784.00 | $33,181.87 | $48,123.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,320.44 / $25,928.54 / $39,791.41
| Facility | | $15,320.44 | $25,928.54 | $39,791.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,147.93 / $29,147.93 / $35,393.92
| Facility | | $29,147.93 | $29,147.93 | $35,393.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,556.86 / $36,633.42 / $63,453.41
| Facility | | $14,556.86 | $36,633.42 | $63,453.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,951.90 / $28,919.70 / $39,492.50
| Facility | | $15,951.90 | $28,919.70 | $39,492.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,412.27 / $23,864.00 / $39,791.41
| Facility | | $14,412.27 | $23,864.00 | $39,791.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $15,285.03 / $21,843.29
| Facility | | $2,621.40 | $15,285.03 | $21,843.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,227.15 / $24,355.98 / $40,444.12
| Facility | | $8,227.15 | $24,355.98 | $40,444.12 |