- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,731.10 / $22,058.10 / $30,122.20
| Facility | | $12,731.10 | $22,058.10 | $30,122.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,872.00 / $23,529.75 / $35,691.01
| Facility | | $11,872.00 | $23,529.75 | $35,691.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,685.42 / $21,047.52 / $30,350.25
| Facility | | $11,685.42 | $21,047.52 | $30,350.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,232.12 / $22,232.12 / $26,996.14
| Facility | | $22,232.12 | $22,232.12 | $26,996.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,514.43 / $31,134.46 / $34,136.56
| Facility | | $27,514.43 | $31,134.46 | $34,136.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,167.10 / $21,587.20 / $29,820.00
| Facility | | $12,167.10 | $21,587.20 | $29,820.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,992.73 / $18,241.18 / $30,350.25
| Facility | | $10,992.73 | $18,241.18 | $30,350.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,808.56 / $16,660.61
| Facility | | $2,621.40 | $11,808.56 | $16,660.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,275.13 / $16,871.75 / $30,848.11
| Facility | | $6,275.13 | $16,871.75 | $30,848.11 |