- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,690.00 / $21,193.20 / $30,289.30
| Facility | | $11,690.00 | $21,193.20 | $30,289.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,918.00 / $23,992.36 / $32,332.00
| Facility | | $10,918.00 | $23,992.36 | $32,332.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,237.00 / $19,001.16 / $28,840.08
| Facility | | $11,237.00 | $19,001.16 | $28,840.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,360.43 / $21,360.43 / $25,937.67
| Facility | | $21,360.43 | $21,360.43 | $25,937.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,969.54 / $19,249.23 / $28,500.09
| Facility | | $10,969.54 | $19,249.23 | $28,500.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,669.30 / $21,193.20 / $28,941.20
| Facility | | $11,669.30 | $21,193.20 | $28,941.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,675.03 / $17,500.05 / $27,279.63
| Facility | | $10,675.03 | $17,500.05 | $27,279.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,269.92 / $14,386.58
| Facility | | $2,621.40 | $10,269.92 | $14,386.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,029.09 / $16,339.86 / $29,638.60
| Facility | | $6,029.09 | $16,339.86 | $29,638.60 |