- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,511.09 / $29,492.00 / $42,149.90
| Facility | | $16,511.09 | $29,492.00 | $42,149.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,508.00 / $32,817.90 / $48,301.00
| Facility | | $16,508.00 | $32,817.90 | $48,301.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,623.58 / $26,441.57 / $40,578.73
| Facility | | $15,623.58 | $26,441.57 | $40,578.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $29,724.66 / $29,724.66 / $36,094.24
| Facility | | $29,724.66 | $29,724.66 | $36,094.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,375.64 / $29,372.27 / $42,475.03
| Facility | | $23,375.64 | $29,372.27 | $42,475.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,267.60 / $29,492.00 / $40,273.90
| Facility | | $16,267.60 | $29,492.00 | $40,273.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,697.44 / $24,148.81 / $40,578.73
| Facility | | $14,697.44 | $24,148.81 | $40,578.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $15,341.85 / $21,927.76
| Facility | | $2,621.40 | $15,341.85 | $21,927.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,389.94 / $22,738.16 / $41,244.37
| Facility | | $8,389.94 | $22,738.16 | $41,244.37 |