- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,115.10 / $27,402.60 / $37,420.60
| Facility | | $15,115.10 | $27,402.60 | $37,420.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,400.00 / $28,297.09 / $41,530.51
| Facility | | $13,400.00 | $28,297.09 | $41,530.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,516.70 / $24,568.27 / $35,970.91
| Facility | | $14,516.70 | $24,568.27 | $35,970.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,618.78 / $27,618.78 / $33,537.08
| Facility | | $27,618.78 | $27,618.78 | $33,537.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,694.98 / $27,025.75 / $38,483.74
| Facility | | $12,694.98 | $27,025.75 | $38,483.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,859.70 / $26,817.60 / $37,031.80
| Facility | | $13,859.70 | $26,817.60 | $37,031.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,656.18 / $22,627.35 / $35,332.19
| Facility | | $13,656.18 | $22,627.35 | $35,332.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,348.87 / $18,964.64
| Facility | | $2,621.40 | $13,348.87 | $18,964.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,781.81 / $20,959.63 / $38,322.35
| Facility | | $7,781.81 | $20,959.63 | $38,322.35 |