- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,637.80 / $30,559.60 / $41,731.80
| Facility | | $17,637.80 | $30,559.60 | $41,731.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,558.00 / $29,127.00 / $42,145.47
| Facility | | $14,558.00 | $29,127.00 | $42,145.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,392.86 / $27,398.73 / $41,585.96
| Facility | | $15,392.86 | $27,398.73 | $41,585.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30,800.68 / $30,800.68 / $37,400.82
| Facility | | $30,800.68 | $30,800.68 | $37,400.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,201.69 / $30,900.49 / $39,129.29
| Facility | | $9,201.69 | $30,900.49 | $39,129.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,856.40 / $29,907.20 / $41,298.10
| Facility | | $16,856.40 | $29,907.20 | $41,298.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,640.00 / $25,022.98 / $38,970.94
| Facility | | $14,640.00 | $25,022.98 | $38,970.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,717.42 / $19,512.58
| Facility | | $2,621.40 | $13,717.42 | $19,512.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,693.65 / $23,561.27 / $42,737.39
| Facility | | $8,693.65 | $23,561.27 | $42,737.39 |