- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,444.40 / $23,294.10 / $31,810.10
| Facility | | $13,444.40 | $23,294.10 | $31,810.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,856.00 / $24,967.02 / $37,108.80
| Facility | | $11,856.00 | $24,967.02 | $37,108.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,469.85 / $20,884.72 / $30,850.58
| Facility | | $12,469.85 | $20,884.72 | $30,850.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,477.85 / $23,477.85 / $28,508.82
| Facility | | $23,477.85 | $23,477.85 | $28,508.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,557.38 / $30,395.08 / $44,070.54
| Facility | | $21,557.38 | $30,395.08 | $44,070.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,848.80 / $23,294.10 / $31,730.00
| Facility | | $12,848.80 | $23,294.10 | $31,730.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,733.23 / $19,234.80 / $30,034.78
| Facility | | $11,733.23 | $19,234.80 | $30,034.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $11,559.87 / $16,268.26
| Facility | | $2,621.40 | $11,559.87 | $16,268.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,626.74 / $17,959.59 / $32,576.63
| Facility | | $6,626.74 | $17,959.59 | $32,576.63 |