- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,464.00 / $27,621.60 / $37,719.80
| Facility | | $15,464.00 | $27,621.60 | $37,719.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,337.00 / $29,596.02 / $40,968.00
| Facility | | $14,337.00 | $29,596.02 | $40,968.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,980.00 / $25,432.00 / $37,588.00
| Facility | | $13,980.00 | $25,432.00 | $37,588.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,839.58 / $27,839.58 / $33,805.21
| Facility | | $27,839.58 | $27,839.58 | $33,805.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,636.21 / $22,928.12 / $40,554.96
| Facility | | $10,636.21 | $22,928.12 | $40,554.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,235.90 / $27,621.60 / $37,327.80
| Facility | | $15,235.90 | $27,621.60 | $37,327.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,765.35 / $22,842.04 / $35,294.24
| Facility | | $13,765.35 | $22,842.04 | $35,294.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,621.40 / $13,113.39 / $18,614.53
| Facility | | $2,621.40 | $13,113.39 | $18,614.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,857.86 / $23,262.73 / $38,628.73
| Facility | | $7,857.86 | $23,262.73 | $38,628.73 |