- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,920.00 / $21,610.10 / $29,510.50
| Facility | | $11,920.00 | $21,610.10 | $29,510.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,768.00 / $21,590.34 / $34,139.03
| Facility | | $10,768.00 | $21,590.34 | $34,139.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,448.11 / $19,374.93 / $29,407.41
| Facility | | $11,448.11 | $19,374.93 | $29,407.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,780.62 / $21,780.62 / $26,447.90
| Facility | | $21,780.62 | $21,780.62 | $26,447.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,794.36 / $27,154.04 / $37,546.89
| Facility | | $10,794.36 | $27,154.04 | $37,546.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,898.80 / $20,756.20 / $29,253.00
| Facility | | $11,898.80 | $20,756.20 | $29,253.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,769.48 / $17,844.30 / $28,386.33
| Facility | | $10,769.48 | $17,844.30 | $28,386.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $10,683.29 / $14,965.65
| Facility | | $2,621.40 | $10,683.29 | $14,965.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,040.63 / $16,661.29 / $30,221.64
| Facility | | $6,040.63 | $16,661.29 | $30,221.64 |