- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,222.10 / $18,258.59 / $26,942.80
| Facility | | $10,222.10 | $18,258.59 | $26,942.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,407.89 / $20,407.89 / $20,407.89
| Facility | | $20,407.89 | $20,407.89 | $20,407.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,921.00 / $22,179.32 / $32,880.00
| Facility | | $10,921.00 | $22,179.32 | $32,880.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,774.23 / $17,422.08 / $26,105.47
| Facility | | $9,774.23 | $17,422.08 | $26,105.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,402.63 / $18,402.63 / $22,346.05
| Facility | | $18,402.63 | $18,402.63 | $22,346.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,556.86 / $25,765.17 / $32,433.07
| Facility | | $14,556.86 | $25,765.17 | $32,433.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,071.29 / $18,258.59 / $26,608.90
| Facility | | $10,071.29 | $18,258.59 | $26,608.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,196.85 / $15,099.14 / $26,105.47
| Facility | | $9,196.85 | $15,099.14 | $26,105.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,852.57 / $13,766.39
| Facility | | $2,621.40 | $9,852.57 | $13,766.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $16,007.09 / $26,758.00
| Facility | | $5,404.00 | $16,007.09 | $26,758.00 |