- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,557.10 / $18,856.90 / $25,759.00
| Facility | | $10,557.10 | $18,856.90 | $25,759.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,224.00 / $20,971.02 / $29,265.85
| Facility | | $10,224.00 | $20,971.02 | $29,265.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,989.60 / $16,906.54 / $25,660.84
| Facility | | $9,989.60 | $16,906.54 | $25,660.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,005.73 / $19,005.73 / $23,078.38
| Facility | | $19,005.73 | $19,005.73 | $23,078.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,244.48 / $23,222.85 / $39,062.19
| Facility | | $17,244.48 | $23,222.85 | $39,062.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,401.40 / $18,856.90 / $25,750.80
| Facility | | $10,401.40 | $18,856.90 | $25,750.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,498.25 / $15,593.97 / $24,404.32
| Facility | | $9,498.25 | $15,593.97 | $24,404.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $9,247.79 / $12,867.23
| Facility | | $2,621.40 | $9,247.79 | $12,867.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,404.00 / $14,538.61 / $26,371.34
| Facility | | $5,404.00 | $14,538.61 | $26,371.34 |